Vance County mental health provider arrested for fraud
Release date: 9/11/2012
Fraud scheme busted by AG Cooper’s s expanded Medicaid Investigations Division
Raleigh: A Vance County mental health care provider accused of cheating taxpayers and the Medicaid system was arrested today on 16 felony counts, Attorney General Roy Cooper announced Tuesday.
, age 41 of Henderson, was arrested today in Wake County on charges including medical assistance provider fraud, offering kickbacks, and obtaining property by false pretenses. The alleged felonies involve a total of $103,075 in attempted fraud and carry a potential sentence of 182 months in prison.
“Ripping off Medicaid wastes taxpayer money, hurts needy patients, and drives up health care costs,” Cooper said. “Those who cheat Medicaid should expect to pay the price.”
Cooper’s Medicaid Investigations Division
(MID) began investigating Faison, a counselor with Prodigious Health Services, in December 2011 following a call from a Medicaid recipient. The caller said that Prodigious had billed North Carolina Medicaid using her family’s Medicaid recipient numbers even though no one in her family had ever received any type of medical services from Prodigious.
MID investigators uncovered what they contend was a system of kickbacks and billing for services not actually provided. Faison allegedly offered several people $25 for each Medicaid recipient referral or Medicaid recipient number that they could collect for Prodigious. Investigators say that Medicaid recipients were offered incentives, such as payment of utility bills and toys for their children, to induce them to fill out forms with their family’s Medicaid recipient numbers. Faison and Prodigious would then bill NC Medicaid using those recipients’ numbers even though they had not provided them any medical services, investigators allege.
Today’s arrest is the latest in a sweep kicked off last December with the arrests of 20 people in 10 different counties for engaging in various schemes to defraud NC Medicaid our of more than half a million dollars. Of those charged in December, 16 have been convicted thus far.
Cooper’s Medicaid fraud team has recouped nearly $500 million over the past decade and helped to convict hundreds of individuals on criminal charges. The division has nearly doubled in size in recent years, allowing it to take on 46 percent more investigations than before.
“With more investigators and attorneys looking for Medicaid fraud, we expect to root out even more wrongdoing,” Cooper said.
The MID investigates fraud and abuse of Medicaid benefits by hospitals, doctors, pharmaceutical companies, medical equipment companies, mental health and personal care providers, ambulance services and others. The division also investigates patient abuse and neglect in nursing homes and other facilities that receive Medicaid funds. The unit includes attorneys, investigators and State Bureau of Investigation agents who work closely with United States Attorneys, District Attorneys, and other state and federal law enforcement agencies.
Prodigious is a mental health provider in Vance County; however, charges were issued in Wake County because Faison and Prodigious submitted the fraudulent bills to the N.C. Division of Medical Assistance (DMA) in Raleigh, where they were processed for payment.
The Program Integrity Section of the DMA, the SBI, and the Wake County District Attorney’s Office assisted in the case. SBI agents served the arrest warrants on Faison and also served him with two outstanding warrants from Guilford and Vance counties, alleging sexual battery and assault on a female, charges unrelated to the Medicaid fraud investigation.
Media contact: Noelle Talley (919) 716-6413