In an absolute jaw-dropper of a press release from the United States Attorney’s Office for the Eastern District of North Carolina, it was revealed that four Medicaid fraudsters in the state had managed to steal nearly $13 million from the Medicaid program. They apparently did so through a massive scheme involving kickbacks and a fake substance abuse facility, with the fraudsters paying major kickbacks to the drug addicts to try and cover up what they were up to.
Announcing as much, the DOJ press statement on the incident and trial revealed that a judge had handed down prison sentences against all four. It said, “A federal judge has handed down more than 14 years in federal prison to participants in a $12.7 Million Medicaid fraud scheme that paid more than $1 Million in kickbacks to drug addict patients.”
Continuing, the statement added that the fake facility in which they were ripping off the government had been shut down, along with huge fines being foisted on all involved. It said, “The case also resulted in the permanent closure of the fake substance abuse facility that carried out the crime, a $15 Million dollar fine, and the seizure of more than $6 Million in criminal proceeds, including cash, cars, and homes.”
Describing the kickback scheme in somewhat more detail later on, along with the names of those who were involved, saying, “According to court documents, Keke Komeko Johnson, 53, of Goldsboro; Francine Sims Super, 64, of Kinston; Brandon Eugene Sims, 40, of Manvel, Texas; and Kimberly Mable Sims, 39, of Snow Hill; operated Life Touch, LLC, a purported substance abuse facility operating in Kinston and Goldsboro, and 1st Choice Healthcare Services, a urine drug screening company. Between 2018 and 2023, Inmates Johnson and Super oversaw payments of more than $1 Million in illegal kickbacks to Life Touch’s Medicaid patients, who were drug users. They paid these kickbacks to lure patients to show up for costly substance abuse and lab services”.
They were apparently caught by the “Medicaid Investigations Division”, which managed to help other federal agents find and confiscate huge sums from them: “During the investigation, federal agents seized and forfeited more than $6 Million in assets in the form of cash, real estate, and other assets. In November 2023, after becoming aware of the criminal investigation, Inmate Brandon Sims withdrew more than $1 Million in cash from a bank account, hiding it in a safe at his Texas home. Agents executed a search warrant and seized $1.3 million in cash, a 2021 Rolls Royce Cullinan, a 2021 Chevrolet Corvette, and a 2020 Chevrolet Silverado. Agents seized Millions more in other real property.” Those involved face years and prison and millions in fines in addition to the property that was stolen from them.
U.S. Attorney Ellis Boyle, commenting on the matter as part of the press statement, said, “This is shocking Minnesota-Somali-style fraud right here in North Carolina. For too long, government has allowed grifters to steal taxpayer dollars with impunity. Here, these vultures exploited particularly susceptible drug abusers trying to recover their lives and dignity. Shameful abuse, no remorse. They better learn, and everyone should get the message. Cheaters. Never. Win.”
Similarly, Reid Davis, the FBI Special Agent in Charge North Carolina, said, “Healthcare Fraud robs American taxpayers and betrays the very programs meant to protect our most vulnerable citizens. In this case, more than $12 million was stolen by these defendants directly from those who need it most.”
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Adding to that, Davis said, “These defendants now face more than 170 months in federal prison, over $30 million in restitution to North Carolina Medicaid, and a $15 million fine. This outcome sends a clear message: those who defraud public healthcare programs will be held accountable.”
Watch Dr. Oz comment on the fraud in California in late October:
Featured image credit: screengrab from the DOJ press release