Medicaid Queenpin Convicted of $1.3M Scam

A Charlotte woman has been convicted of swindling the South Carolina Medicaid program out of $1.3 million in a brazen scheme that also involved COVID-19 relief funds and money laundering.

A federal jury in North Carolina found Ashley Nicole Cross, 41, of Charlotte, guilty of healthcare fraud, making false statements and writings relating to a healthcare matter, promotional money laundering, wire fraud, and conspiracy. The verdict was announced by U.S. Attorney Dena J. King, who credited the FBI and the South Carolina Medicaid Fraud Control Unit with assisting in the case.

Cross owned and operated Odyssey Health Group (OHG), a Charlotte-based company enrolled with SC Medicaid to provide outpatient behavioral health services. But instead of providing care, Cross used the personal identifying information of qualified Medicaid beneficiaries to file reimbursement claims totaling $1.3 million dollars.

According to trial evidence, Cross bought the personal info of Medicaid beneficiaries she used to submit claims, and even created fake clinical service notes to give the appearance that OHG’s claims were legitimate. When auditors came knocking, Cross submitted fictitious patient medical records and made false statements to cover up the scheme.

In addition to the Medicaid fraud, Cross was also found guilty of executing a scheme to obtain fraudulent Paycheck Protection Program (PPP) loans for her companies and a purported event planning business owned by her boyfriend. She obtained more than $287,000 in COVID-19 relief funds for her companies and Gucci International Inc.

Cross was remanded into custody after the jury returned its verdict, and a federal district court judge will determine her sentence after considering the U.S. Sentencing Guidelines and other statutory factors. The FBI investigated the case with substantial assistance from the South Carolina Attorney General’s Office, Medicaid Fraud Control Unit, and the Small Business Administration’s Office of Inspector General.

Assistant U.S. Attorneys Michael E. Savage and Cassye Cole, and Special Assistant U.S. Attorney Kristina Fleisch prosecuted the case.

The conviction is a major blow to Medicaid scammers and COVID-19 relief abusers, and serves as a reminder that those who prey on vulnerable populations will be held accountable. Cross’s sentencing is scheduled for a later date.

This case was investigated by the FBI, with assistance from the South Carolina Attorney General’s Office, Medicaid Fraud Control Unit, and the Small Business Administration’s Office of Inspector General.

The U.S. Attorney’s Office in Charlotte is committed to protecting the integrity of the Medicaid program and ensuring that those who abuse it are brought to justice.

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