STATESVILLE, N.C. – A leader in a Medicaid fraud conspiracy has been sentenced to 40 months in prison for her role in a scheme that bilked the healthcare system out of $336,000. Betty Ann Cook, 56, of Sparta, N.C., was sentenced on May 6, 2013 to serve 40 months in prison and two years of supervised release for health care fraud conspiracy and money laundering, announced Anne M. Tompkins, U.S. Attorney for the Western District of North Carolina.
Cook, who owned Families First Home Health Care, a home health care company located in Alleghany Co., N.C., pleaded guilty on April 25, 2012 to one count of health care fraud conspiracy and one count of money laundering conspiracy. The scheme involved submitting false and fraudulent claims to Medicaid seeking reimbursement for patient care services that were either not provided, not authorized by a physician, or were not based upon a valid in-home eligibility assessment performed by a qualified registered nurse.
Court records indicate that during the relevant time period, Cook and her co-conspirators, which included PCS aides and Medicaid recipients, participated in a “fee-splitting” scheme. The scheme involved billing Medicaid for patient care services that were not rendered and then splitting the fraudulently obtained Medicaid reimbursements among the co-conspirators. As a result of the fee-splitting scheme, Cook received over $150,000 as payment to the fraudulent claims.
In addition to the fee-splitting scheme, Cook also submitted fraudulent claims to Medicaid for patient care services allegedly provided to Medicaid recipients, even though the services were not approved by a physician. Cook copied, altered and falsified physician signatures on forms in order to justify the fraudulent billing. At the sentencing hearing, U.S. District Judge Richard L. Vorhees also ordered Cook to pay $325,820.17 in restitution.
Cook has been released on bond since entering her guilty plea. She will be ordered to report to a federal facility, at which time she will be transferred into the custody of the Federal Bureau of Prisons. Federal sentences are served without the possibility of parole.
Monday’s sentencing of Cook marks the conclusion of a multi-year investigation into Cook and her conspirators. In addition to Cook, 15 other individuals have been convicted in federal and state court in related charges. On April 8, 2013, Crystal Deleon Evans, 34, of Sparta, was sentenced to probation for one count of health care fraud conspiracy. Fourteen other individuals have pleaded guilty in the Allegheny County District Court to misdemeanor charges of conspiracy to commit Medicaid fraud.
The scheme, which spanned from December 2006 to about October 2010, resulted in a loss of $336,000 to the Medicaid system. Cook’s company was enrolled with Medicaid to provide personal care services (“PCS”) such as bathing, dressing, and eating to Medicaid recipients. These types of services are provided by a home health aide in the recipient’s home.
Related Federal Cases
- Ricky McMillian, Conspiracy to Commit Wire Fraud, North Carolina 2023 · North Carolina
- Brent Allan Dilonardo, Conspiracy to Commit Wire Fraud, North Carolina 2016 · North Carolina
- Robert Warren, Crop Insurance Fraud, North Carolina 2003 · North Carolina
- Christopher Bryan Roach, Bank Fraud and Identity Theft, North Carolina 2017 · North Carolina
- Tony McElveen, Bank Fraud and Aggravated Identity Theft, North Carolina 2023 · North Carolina
Key Facts
- State: North Carolina
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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