FBI, U.S. attorney in Charlotte outline new Medicaid fraud schemes in Carolinas
State and federal officials said Monday they flagged over $22 million that four Charlotte residents stole from local Medicaid programs.
The cases are part of a Department of Justice annual takedown of healthcare fraud, with a historic $14.6 billion in fraud discovered nationwide, officials said at a Monday news conference at the U.S. Attorney’s Office in Charlotte.
U.S. Attorney Russ Ferguson of the Charlotte-based Western District of North Carolina, flanked by state Attorney General Jeff Jackson and other state and federal officials, discussed two yearslong healthcare fraud schemes.
One Charlotte woman stole over $1.9 million from the North Carolina Medicaid program between early 2020 and June of 2024, according to a bill of information filed in federal court.
She posed as a licensed clinical addiction specialist and is accused of filing fraudulent claims for drug and therapy treatments. Over a dozen beneficiaries of her so-called services were incarcerated or had died.
She plans to plead guilty to five charges related to money laundering and healthcare fraud and will appear in court in Charlotte later this week, Ferguson said.
South Carolina fraud case
Officials also discussed a separate case, dubbed “Operation Border War,” in which they said three Charlotte residents and five fellow conspirators stole over $21 million from the South Carolina Medicaid program.
The individuals exploited a South Carolina Department of Health and Human Services rule that allows Medicaid providers to enroll companies 25 miles from South Carolina’s border, according to South Carolina Attorney General Alan Wilson, who joined the news conference in Charlotte Monday.
Ferguson characterized the scheme, which ran from June of 2017 to December of 2024, as “very sophisticated.” The conspirators set up false companies and held in-person meetings with licensed behavioral health providers. Then, they submitted fraudulent claims in the names of the healthcare providers, most of whom did not know about the scheme.
The conspirators largely targeted disabled and mentally ill children as the beneficiaries of their invented services, Wilson said.
Ferguson said no money was frozen when the conspirators were indicted. However, he stressed that they will be required to forfeit their assets if convicted.
“We will continue to try to recover that money for years to come until every dollar is returned,” Ferguson said.
Ferguson did not clarify if the nearly $2 million the Charlotte woman stole had already been recovered.
At the press conference, officials from the Carolinas and federal agencies presented a united front.
“If you engage or if you exploit our Medicare and Medicaid programs, we will find the red flags,” Ferguson said. “We will trace the money, we will uncover your scheme and we will bring you to justice.”
