Fayetteville, N.C. Woman Responsible For Creating Fake Patient Files In Medicaid Fraud Conspiracy Is Sentenced Prison
CHARLOTTE, N.C. – Chief U.S. District Judge Frank D. Whitney sentenced to 33 months in prison a Fayetteville, N.C. woman responsible for creating fake patient records in a Medicaid fraud conspiracy, announced Jill Westmoreland Rose, U.S. Attorney for the Western District of North Carolina. Tanisha Melvin, 36, was also ordered to serve three years under court supervision and to pay $392,159.81 as restitution to Medicaid.
John A. Strong, Special Agent in Charge of the Federal Bureau of Investigation (FBI), Charlotte Division joins U.S. Attorney Rose in making today’s announcement.
According to information in filed court documents and today’s sentencing hearing, between October 2012 and August 2013, Melvin was involved in a Medicaid fraud conspiracy organized by the ring’s leader, Cynthia Harlan. Harlan owned and operated “Heartland Consulting and Marketing, Inc.,” a Charlotte-area company, purportedly specializing in the operation of mental health companies and Medicaid reimbursement. According to court records, Harlan executed a Medicaid fraud scheme involving the fraudulent submission of fake reimbursement claims to Medicaid for services that were never actually provided to beneficiaries. Court records show that Harlan relied on a network of conspirators, including Melvin, whom she had recruited to carry out the scheme.
According to court records, as part of the healthcare fraud conspiracy, Melvin was responsible for creating fraudulent patient records for companies purported to provide outpatient mental and behavioral health services, including “Kings of Carolina Care 1” (Carolina Care 1) in Rockingham, N.C., and “United Rehabilitation Services” (URS) in Erwin, N.C. At the direction of Harlan, Melvin fabricated and compiled the sham paperwork in patient files to support the false Medicaid reimbursement claims submitted on behalf of the two companies. These patient files included fabricated intake packets, non-existent mental health problems and made-up treatment for the problems. The patient files were intended to deceive Medicaid auditors in case there was an inquiry about the accuracy of the fake claims. According to court records, during the relevant time period the conspirators attempted to obtain from Medicaid over $1.6 million in fraudulent reimbursement claims. Melvin, Harlan and the other conspirators received a portion of the fraud proceeds for their respective roles in the scheme.
Court records show that after Harlan became aware that she was being investigated for Medicaid fraud, Harlan instructed Melvin to destroy records relevant to the scheme. Melvin destroyed documents and, as directed by Harlan, contacted other members of the conspiracy to alert them to the investigation and to instruct them to destroy documents, emails and text messages for the purpose of obstructing the investigation.
Melvin pleaded guilty in December 2015 to one count of health care fraud conspiracy. Today, she was released on bond following her sentencing hearing and will be ordered to report to the Federal Bureau of Prisons upon designation of a federal facility. All federal sentences are served without the possibility of parole.
In announcing today’s sentence Judge Whitney noted that the crime involved “Scarce taxpayer funds that are to be used to assist those that are the most needy.”
In addition to Melvin, three other members of the conspiracy have already been sentenced to prison. The owners of URS, Alexander Bass and Torrey Darnell Moton, were previously sentenced to 32 and 25 months in prison, respectively, three years of supervised release and were ordered to pay $370,372.37 as restitution to Medicaid. LaChanda Clotiel Parks, who was also responsible for generating some of the fake patient paperwork, was sentenced to 28 months in prison, followed by three years of supervised release, and was ordered to pay $352,565.69 in restitution for her role in the conspiracy. The owners of Carolina Care 1, Tyree Craig Jones and Claude Bernard McCray, have been charged with one count of health care fraud conspiracy. Cynthia Harlan is currently in federal custody on health care fraud conspiracy, aggravated identity theft and obstruction charges.
The investigation was handled by the FBI with assistance from the North Carolina Medicaid Investigations Division. Assistant U.S. Attorney Kelli Ferry is in charge of the prosecution.
The investigation is the work of the Western District’s joint Health Care Fraud Task Force. The Task Force is multi-agency team of experienced federal and state investigators, working in conjunction with criminal and civil Assistant United States Attorneys, dedicated to identifying and prosecuting those who defraud the health care system, and reducing the potential for health care fraud in the future. The Task Force focuses on the coordination of cases, information sharing, identification of trends in health care fraud throughout the region, staffing of all whistle blower complaints, and the creation of investigative teams so that individual agencies may focus their unique areas of expertise on investigations. The Task Force builds upon existing partnerships between the agencies and its work reflects a heightened effort to reduce fraud and recover taxpayer dollars.
If you suspect Medicare or Medicaid fraud please report it by phone at 1-800-447-8477 (1-800-HHS-TIPS), or E-Mail at HHSTips@oig.hhs.gov. To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.