Local News

Nine health providers charged with Medicaid fraud

Posted December 18, 2012 3:36 p.m. EST

— Nine health care providers in five North Carolina counties were charged Tuesday in the state’s continuing crackdown on Medicaid fraud, authorities said.

The suspects – a dentist, home health care workers, a mental health care provider and an HIV case manager – are accused in various schemes that netted about $200,000 in fraudulent payments, according to Attorney General Roy Cooper.

State Bureau of Investigation agents made the arrests in Wake, Cumberland, Dare, Alleghany and Sampson counties, and authorities said more were expected in the coming weeks.

A Medicaid fraud sweep last December resulted in 20 arrests. Seventeen of those suspects have been convicted, and two more are awaiting trial.

“We’re continuing our crackdown to deter those who would commit health care fraud,” Cooper said. “Cheating Medicaid is illegal, and our investigators and attorneys are finding violators and making them pay.”

The suspects arrested Tuesday include:

Gloria Sawyer, HIV case manager, Wake County. Sawyer, owner of I Believe in Miracles, is accused of concealing her felony drug convictions when she applied to be a state Medicaid provider. Authorities said she received more than $100,000 for her services to Medicaid recipients. Sawyer is charged with three counts of obtaining property by false pretenses and two counts of obtaining property by false pretense.

Kellie Hickman, home health care aide, Sampson County. Hickman is accused of submitting false timesheets for care she did not provide to two Medicaid recipients while she worked for United Home Care Inc. The state estimates the loss at $2,932.50, which United Home Care Inc. has already reimbursed. Hickman is charged with two counts of medical assistance provider fraud.

Dr. Francis Bald, dentist, Dare County. Bald, who owns practices in Nags Head and Elizabeth City, is accused of billing Medicaid for extra dental procedures he didn’t perform or were unnecessary. The state estimates the loss at more than $3,180. Bald is charged with medical assistance provider fraud and obtaining property by false pretenses.

James Tillman, mental health provider, Cumberland County. Tillman is accused of falsely representing his educational qualifications in order to provide mental health services. Authorities said he wrongly received more than $74,000 in Medicaid payments for his services. He is charged with three counts of medical assistance provider fraud, three counts of obtaining property by false pretenses and two counts of falsifying documents issued by a postsecondary education institution.

Deborah Aroche, Tammy Atkins, Michelle Bottomly, Jessica Cook, Amy Lyall, home health care aides, Alleghany County. The women, who were employees of Families First Home Health Care, are accused of submitted false timesheets for personal care services they did not provided. The state estimates the loss at more than $21,000. They are each charged with medical assistance provider fraud.

The Attorney General’s Medicaid Investigation Division nearly doubled in size last year to take on more cases. The team of attorneys, investigators, crime analysts and support staff investigate fraud and abuse of Medicaid benefits by patients, health care providers, pharmaceutical companies, ambulance services and others.

Cooper said the division has recouped more than $500 million in the past decade and secured convictions for hundreds of suspects.