For Immediate Release:
Wednesday, August 14, 2024
Contact: Nazneen Ahmed
919-716-0060
(RALEIGH) Attorney General Josh Stein announced today that Valerie Ann Sinclair of Fayetteville pleaded guilty to 21 counts of obtaining property by false pretenses in Moore County Superior Court. Judge Regina M. Joe ordered Sinclair to surrender her clinical mental health counselor supervisor license and pay $71,046.04 in restitution to the North Carolina Medicaid program. She also sentenced Sinclair to 60 months of supervised probation and required Sinclair to immediately serve 90 days of confinement.
“This provider cheated the Medicaid program and made it harder for legitimate providers to perform health care services for people who need them,” said Attorney General Josh Stein. “My office won’t allow bad actors to waste taxpayer dollars.”
From September 11, 2017, through July 7, 2021, Valerie Sinclair repeatedly submitted fraudulent claims to the Sandhills Center, a Local Management Entity/Managed Care Organization (LME/MCO) that managed the care of Medicaid recipients. Her claims were for behavioral health services to 21 Medicaid recipients, including many children, that she had not actually provided. As a result of these fraudulent claims, the Sandhills Center paid Sinclair $71,046.04, and in some cases, the false claims caused other providers’ legitimate claims to be denied.
In February 2024, the Sandhills Center consolidated with Trillium Health Resources. The Sandhills Center detected and reported Sinclair’s fraud to the North Carolina Division of Health Benefits and the North Carolina Department of Justice’s Medicaid Investigations Division (MID). The Sandhills Center continued to provide information to the MID throughout the investigation.
This conviction was obtained in collaboration with District Attorney Mike Hardin.
About the Medicaid Investigations Division (MID)
The Attorney General’s MID investigates fraud and abuse by health care companies and providers, as well as patient abuse and neglect in facilities that are funded by Medicaid. Medicaid is a joint federal-state program that helps provide medical care for people with limited income. To date, the MID has recovered more than $1 Billion in restitution and penalties for North Carolina.
MID receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $8,535,748 for Federal fiscal year (FY) 2024. The remaining 25 percent, totaling $2,845,248, is funded by the State of North Carolina. To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.
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