Two Plead Guilty to Role in Elaborate Medicaid Fraud Scheme
On Friday, January 25, 2013, Leontyne Scott and Karyn McCrimmon entered guilty pleas in Gwinnett County Superior Court before Judge Mark Lewis for their role in an elaborate Medicaid Fraud scheme involving their former employer Diversified Family Solutions (DFS).
Scott, the former Executive Director of DFS, pleaded guilty to one felony count of Medicaid Fraud and was sentenced to two years in prison to be followed by eight years on probation. Scott was also ordered to pay restitution in the amount of $30,361.39 and a fine of $1500.00. McCrimmon, a Licensed Associate Professional Counselor when she worked at DFS, pleaded guilty to one felony count of False Writings and was sentenced to five years on probation and a fine of $1500.00.
DFS was enrolled with the Georgia Medicaid program as a provider of Assertive Community Treatment (ACT), a program for delivery of skilled and intensive mental health services in a community setting to persons with a particular set of mental health issues.
Between March of 2007 and April of 2008, the defendants carried out a fraudulent scheme of billing the Georgia Medicaid program for ACT services that were not provided, or by misrepresenting services that may have been provided but were not properly billable to Medicaid as reimbursable ACT services. This resulted in DFS fraudulently obtaining $980,696.64 in Medicaid payments.
The defendants went to elaborate lengths to conceal the fraudulent scheme from the State by engaging in a pattern of creating false, backdated and forged documents that were placed in the files of consumers for whom DFS had submitted Medicaid claims.
Seven other former employees of DFS and the owner, Wanda Francis, previously entered pleas to felony charges in the case.
Senior Assistant Attorney General Charles M. Richards, Assistant Attorney General Henry Hibbert and former Assistant Attorney General Jorge Correa prosecuted the case on behalf of the State of Georgia. The investigation was led by Investigators Johnny Brooks and Ralph Harper, Nurse Investigator Judith Cooper and Analyst Zwella Boyd with the assistance of the Georgia Department of Community Health’s Office of Inspector General.