A North Carolina corporation was sentenced to 5 years’ probation and ordered to pay a $2,000,000 fine in addition to paying $10,069,361.35 in restitution to the North Carolina Medicaid Program on a charge of Healthcare Fraud, in violation of Title 18, United States Code, Section 1347.
A Perfect Fit for You, Inc., a durable medical equipment provider located in Morehead City, North Carolina, and owned by Margaret A. Gibson, was the defendant in this case.
Between March 2015 and November 2016, one or more employees of A Perfect Fit for You submitted fraudulent billing claims to Medicaid for providing durable medical equipment to Medicaid recipients.
The fraudulent claims contained the personal identifying information of Medicaid recipients who had never ordered nor received any durable medical equipment from A Perfect Fit for You. In fact, some of the patients had been deceased years before the false claims were even submitted.
This scheme resulted in an estimated loss to Medicaid of approximately $10,069,361.35.
After appointment of a receiver, A Perfect Fit for You, Inc. self-reported suspected fraudulent activity to the North Carolina Medicaid Investigations Division. Thereafter, the company cooperated throughout the investigation.
On December 13, 2017, and based on the conduct described above, the United States and State of North Carolina filed a civil complaint under the federal and state False Claims Acts against A Perfect Fit for You, Inc. and Gibson, as well as one of the company’s employees, Shelley P. Bandy.
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Key Facts
- State: North Carolina
- Category: White Collar Crime|Healthcare Fraud|Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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