A Charlotte woman will spend the next 16 years in prison and have to pay $3.1 million in restitution after defrauding Medicaid of $11 million. A story in the Charlotte Observer details the case. Cynthia Teresa Harlan, age 49, was convicted in July and sentenced Nov. 30, 2016.
She was convicted of (one count each) health care fraud conspiracy and obstruction of a health care fraud investigation, and three counts each of making false statements related to health care matters and aggravated identity theft.
The investigation was handled by the FBI, with help from the North Carolina Medicaid Investigations Division. According to the story, Harlan owned a consulting and marketing company in Charlotte that specialized in running mental health companies and Medicaid reimbursement. Evidence at the trial showed she used accomplices to submit fake Medicaid claims for services that never took place, according to Jill Westmoreland Rose, U.S. Attorney for the Western District of North Carolina. Tanisha Melvin, 36, was one such accomplice. She created the fake patient records. She was sentenced to 33 months in prison back in April, according to this release from the Department of Justice, U.S. Attorney’s Office for the Western District of North Carolina. Melvin was also ordered to serve three years under court supervision and to pay $392,159.81 as restitution to Medicaid.
Harlan would go to mental health practitioners, owners of outpatient mental and behavioral health services companies, patient recruiters and more and recruit them for the scheme. The made-up paperwork was riddled with fake mental health diagnoses, false dates of service and fake treatment plans.
According to the Department of Justice release, court records show that during the relevant time period the conspirators attempted to obtain over $1.6 million in fraudulent reimbursement claims from Medicaid. Melvin, Harlan and the other conspirators received a portion of the fraud proceeds for their respective roles in the scheme.
Thirteen others have been convicted in the case, including Melvin, who we mentioned earlier. Yet another accomplice faces trial in January.
If you suspect Medicare or Medicaid fraud please report it by phone at 800-447-8477 (1-800-HHS-TIPS), or E-Mail at HHSTips@oig.hhs.gov.
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