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Attorney General Josh Stein Announces Two Health Care Fraud Sentencings

For Immediate Release:
Friday, October 29, 2021

Contact:
Nazneen Ahmed (919) 716-0060

(RALEIGH) Attorney General Josh Stein today announced that James Aaron Lawson and Tanisha Latoy Darden each pleaded guilty to attempted medical assistance provider fraud. They were sentenced to 45 days in prison, with their prison sentences suspended in lieu of 18 months of supervised probation. Lawson was ordered to pay $1,020 and Darden was ordered to pay $855 in restitution to A Caring Heart, a Medicaid provider in Clinton.

“These health care workers cheated the Medicaid program to take money they did not earn,” said Attorney General Josh Stein. “That’s illegal, and it’s a waste of taxpayer resources. My office will hold accountable health care providers when they break the law.”

Lawson and Darden were rehabilitation technicians at A Caring Heart. From April to May 2020, they submitted false timesheets claiming to have provided services to a Medicaid recipient, when in fact they were not working those hours. They were then paid for time they did not work. A Caring Heart submitted reimbursement claims for this time to Eastpointe, a Medicaid Managed Care Organization-Local Management Entity, and was reimbursed. A Caring Heart has since reimbursed Eastpointe for these false claims, and Darden and Lawson were ordered today to reimburse A Caring Heart.

These cases originated from a referral by the North Carolina Department of Health Benefits and Eastpointe, and these convictions were obtained by the North Carolina Department of Justice’s Medicaid Investigations Division and the Honorable Ernie Lee, District Attorney for Prosecutorial District 5.

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 $900 million in restitution and penalties for North Carolina.

The Medicaid Investigations Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $6,160,252 for Federal fiscal year (FY) 2020. The remaining 25 percent, totaling $2,053,414 for FY 2020, 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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