WRAL Investigates

Medicaid fraud earns Durham woman a 6-year prison sentence

Posted June 12, 2015 3:09 p.m. EDT

WRAL Investigates

— Almost three years after investigators first began looking at the books of a Durham-based health care company, the CEO was sentenced Thursday to almost six years in prison for Medicaid fraud.

Tracie Yvette Clay, 46, chief executive of N.C. Behavioral Health and Counseling Services, also faces a fine of $990,099.

Last September, Clay pleaded guilty to three charges of health care fraud. Investigators said she submitted claims for services for at least 56 clients – none of whom received the services. She received approximately $1 million from Medicaid for those services, and she used the money to buy a Cadillac Escalade, a Mercedes and a pool, according to court records.

Clay was the subject of a WRAL investigation in July 2012 after records showed that N.C. Behavioral Health billed Medicaid for more than $712,000 in counseling services in 2011, including 3,237 therapy sessions for a total of 7,920 hours. That’s nearly 22 hours a day, every day of the year, all billed in the name of one psychologist, Eunice Ngumba-Gatabaki.

Gatabaki told WRAL News that she had never heard of the agency and was angry and concerned that the business used her provider number for all of its Medicaid billing.

“Instead of working within the mission of Medicaid to help the poor, the elderly, and the disabled obtain necessary medical services, this defendant defrauded both the victims and the taxpayers," United States Attorney Ripley Rand said.