Seven Plead Guilty to Health Care Fraud Conspiracy Involving False Billing for Children’s Behavioral Health Services | USAO-SC

Columbia, South Carolina — Acting US Attorney M. Rhett DeHart announced today that seven defendants were guilty of indictment relating to a Medicaid fraud conspiracy resulting from improper billing of behavioral health services for children .

The defendants are all former owners, employees, or business associates of Wrights Care Services, LLC, a North Carolina-based provider of behavioral rehabilitation health services. Today’s admission of guilt by former owner Daniel Wright marks the seventh admission of guilt in the case, the result of years of investigation and prosecution conducted by the U.S. Attorney General and the Federal Bureau of Investigation (FBI) in conjunction with the South Carolina Attorney General’s office .

“Healthcare fraud will be fully prosecuted.” Acting US Attorney DeHart said. “It’s a betrayal of public trust and diverting scarce resources away from Americans in need of health insurance.”

“Wright and the other defendants have used Medicaid for several years, which benefits over a million low-income South Carolinas,” said Susan Ferensic, FBI special agent in charge of Columbia Field Office. “Health fraud remains at the forefront of the crimes our office is investigating, and this case should serve as an example to individuals and businesses alike that these programs will not be tolerated.”

“This fraud system not only stole millions of dollars from our hardworking taxpayers, but it also stole legitimate programs to help children who needed it,” said South Carolina Attorney General Alan Wilson. “This case is another example of our office’s close and productive collaboration with the US Attorney General and the FBI, and I would like to commend you for your diligence in this case.”

The evidence obtained during the investigation showed that in 2014 Wrights Care Services was approved by South Carolina Medicaid to provide behavioral health services. Wrights Care had affiliated franchise locations across South Carolina including Columbia, Spartanburg, Pickens, Cheraw, Society Hill, Bennettsville, Hartsville, and Conway. From the outset, Wrights Care Services failed to provide qualified behavioral health services to the children it cared for. However, in order to get payment from Medicaid, members of the conspiracy filed inflated bills and incorrect medical records. In the case of a franchise, members of the conspiracy began charging Medicaid for services before the franchise opened its doors.

In 2015, South Carolina Medicaid attempted to audit Wright’s Care Services, and members of the conspiracy met at a “note party” in Columbia to forge signatures and forged records to aid the audit. During the program, Wrights Care and its affiliate franchises submitted Medicaid bills for $ 6,657,810.43.

The following defendants have so far pleaded guilty:

• Daniel Wright, 39, from Greensboro, North Carolina
• Glenn Pair, 35, from Baltimore, Maryland
• John David Zachariah Wallace, 40, of Sugar Land, Texas
• Kathleen Dubose, 54, from Greensboro, North Carolina
• Sherel Lawson, 47, from Summerfield, North Carolina
• Latasha Bethea, 37, from Fayetteville, North Carolina
• Tonya Strickland Hall, 47, from Greensboro, North Carolina

Each defendant faces a maximum five-year sentence in federal prison for conspiracy to defraud the United States. Each defendant also faces a fine of up to $ 250,000 and 3 years of custody to comply with the sentence. United States District Judge Mary G. Lewis accepted the guilty guilty guilty admissions and will convict the defendants after receiving and reviewing presentation reports prepared by the U.S. Parole Department.

This case was investigated by FBI Special Agents Neil Power and Mark McMahon and Assistant Attorney General Brent Yandle and Assistant Chief Investigator Jamie Seales of the South Carolina Attorney General’s Medicaid Fraud Control Unit. US Assistant Attorney Brook Andrews is pursuing the case.

#####

https://www.justice.gov/usao-sc/pr/seven-plead-guilty-health-care-fraud-conspiracy-involving-false-billing-children-s