North Carolina Resident Pleads Guilty In Medicaid Fraud Case

Residents of North Carolina rely on the state’s Medicaid program to cover their health care. Sometimes bad actors try to take advantage of the program, using fraud to obtain payments.

A North Carolina man recently pled guilty to conspiring in a scheme to defraud the Medicaid program and launder the proceeds.

Scheme to defraud

The man worked for an independent laboratory that processed urine samples for drug tests. He also worked for a mental health and substance abuse services treatment company. As part of the scheme, the man paid a third-party entity to enroll troubled youth and other Medicaid beneficiaries in behavioral health services. After enrollment, the laboratory performed unnecessary drug screening tests on the individuals and billed North Carolina Medicaid for the tests. The payments to the recruiting company were unlawful kickbacks from the drug test reimbursements.

Money laundering activities

In addition to scheming to get unlawful reimbursement from Medicaid, the man also engaged in a money laundering scheme to shield the funds from kickbacks. To launder the money, the parties to the scheme used a separate company owned by one of the persons recruiting members for the mental health and drug treatment services.

The company sent fake invoices to the behavioral health services entity showing that it had provided various services, such as mentorship, community engagement and development. The company did not give any of these services but received kickbacks for the recruitment efforts.

Federal and state investigators aggressively pursue persons for fraud and other crimes involving government money. If you believe you might be under investigation or have been notified of charges against you, seek out quality criminal defense counsel immediately.