Erika James, Federal Fraud, Louisiana 2023

NEW ORLEANS, LA – In a disturbing case of federal fraud, Erika James, a 49-year-old woman from New Orleans, was sentenced to five years of probation for creating and endorsing fraudulent invoices, resulting in a loss of funds for a Federally Qualified Health Center and AIDS Service Organization.

According to court documents, James, a Denial Specialist at Company 1, created fraudulent invoices with falsified supporting documents, such as explanation of benefits documents from insurance companies, between March 2020 and April 2021.

James endorsed checks issued to patients in higher amounts than the usual range of the refund amount, made claims in the system that made it appear that patients came into Company 1 and paid out of pocket for services, and had the Finance Department issue patient refund checks that she would then deposit into her personal bank account.

James also filed additional claims with the Louisiana Health Access Program (LAHAP) in December 2020 and told LAHAP to mail the checks to her residence, which were made out to Company 1. She then proceeded to deposit those checks into her personal bank account.

U.S. Attorney Duane A. Evans praised the work of the United States Department of Health and Human Services – Office of Inspector General in uncovering the fraud. Assistant U.S. Attorneys J. Ryan McLaren and Kathryn McHugh were in charge of the prosecution.

The maximum sentence for James’ crime was ten years’ imprisonment, up to three years of supervised release, up to a $250,000 fine, and a mandatory $100 special assessment fee.

James’ sentencing comes as a warning to others who may be tempted to engage in similar fraudulent activities. The case highlights the importance of vigilance and accountability in ensuring that taxpayer dollars are used for their intended purpose.

Related Federal Cases