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Prison sentence in Medicaid fraud case

A man who owned a South Carolina counseling service was sentenced to five years in prison on charges of Medicaid fraud in November 2019. The 38-year-old man owned New Dominion Community Services, which operated offices in Greenville, Anderson and Richland counties. The service was an approved provider under South Carolina's Medicaid program. However, in addition to claims for legitimate services, the man reportedly submitted false claims between 2015 and 2017 for counseling services that were never provided, receiving $400,000 in unearned Medicaid reimbursements from the program.

After an investigation by the state Attorney General's office, the man was arrested and charged. The man reached an agreement with prosecutors on the Medicaid fraud charges, pleading guilty in April to obtaining property under false pretenses, a felony charge. The charge can carry up to a 10-year prison sentence, but he was sentenced to five years as part of the agreement. State officials praised the sentence, saying that the man's offenses cheated taxpayers. They also urged that it be considered a deterrent for other providers considering submitting false billing to Medicaid. The man's attorney said that his client will be paying back as much money as possible.

Investigation and prosecution of Medicare and Medicaid fraud at both the state and federal levels has escalated. Public exposure of major fraud cases have highlighted these issues, especially as expanded public healthcare programs are the subject of political debate. As a result, various agencies have poured funding and resources into investigating and prosecuting white collar crimes linked to healthcare billing and insurance fraud.

Professionals who are accused of Medicaid fraud or who are facing investigation for issues related to fraud might benefit from reaching out to a criminal defense attorney. A lawyer may be able to challenge prosecution assertions, resolve cases without formal charges and minimize the risk of a felony conviction.

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