January 04, 2012
Atlanta Man Sentenced to Prison for Medicaid Fraud Involving HIV Patients
George Boyd has been sentenced in DeKalb County Superior Court to 15 years, with the first three years to be served in prison, after pleading guilty to one count of Medicaid Fraud (O.C.G.A. § 49-4-146.1(b)(1)) and two counts of False Writings (O.C.G.A. § 16-10-20). Boyd, who owned and operated a company known as Northwest Ministry, Inc., enrolled in the Medicaid program as a provider of case management services to HIV patients.
In order to be reimbursable by Medicaid, HIV case management services should include real services, such as assisting HIV patients with gaining access to needed medical, social, nutritional and/or educational services. Between June 2005 and November 2009, Boyd billed the Medicaid program approximately $305,000.00 for case management services that were never actually provided. Additionally, in response to two Medicaid Fraud Control Unit subpoenas for records, Boyd falsified patient charts in order to hide his fraudulent conduct.
The investigation revealed that Boyd gained access to consumers’ social security numbers and personal information by volunteering at a support organization for HIV patients; and by directly paying HIV patients for their personal information. He would then use this information to bill Medicaid for services he did not provide.
The investigation also found that Boyd billed the Medicaid program for so-called “charity” work that he performed through his company. For instance, Boyd would receive toy donations, and then hold a toy giveaway for the children of HIV patients only. At the toy giveaway, the HIV patients were required to provide their Medicaid and other personal information in order to participate in the giveaway. Boyd would then bill Medicaid as though he had provided reimbursable case management services to each HIV patient who had attended his toy giveaway.
Judge Daniel M. Coursey, who sentenced Boyd on December 28, 2011, also ordered restitution in the amount of $284,000.00 and prohibited Boyd from participating in the Georgia Medicaid program during the duration of his probation.
Assistant Attorney General Jorge I. Correa prosecuted the case on behalf of the State of Georgia.