Sunday, August 26, 2012

Charlotte Elizabeth Grimes charged with Medicaid fraud

A Charlotte counselor was arrested last week and is accused in a fraudulent scheme worth about $650,000 from Medicaid.

The U.S. Attorney’s Office stated that Charlotte Elizabeth Garnes, a 37-year-old licensed counselor, “rented out” her Medicaid provider number and allowed others to file for Medicaid reimbursement claims for mental and behavior health services that were never performed by Mrs. Garnes.

Garnes was arrested Wednesday in Goldsboro and charged with health care fraud conspiracy and obstruction of official proceedings. If she is convicted of both charges, Garnes could face up to 30 years in prison and a fine of up to $500,000.

According to court documents, the fraudulent claims occurred between March 2009 and April 2011. Garnes conspired with two other women, Teresa Marible and Michele Jackson, to allow Marible and Jackson to submit the claims through Garnes’ company, Charlotte’s Insight.

Prosecutors allege that Garnes kept a percentage of the Medicaid reimbursements received for the claims which list her as the attending clinician.

At one point in 2009, Garnes represented that she provided 69 hours of mental and behavior health services in a single day, according to the indictment. Other claims were filed to Medicaid for counseling services rendered during a time when Garnes wasn’t even in the country. At the time, she was working for a defense contractor at military bases, prosecutors stated.

Medicaid paid Garnes and her co-conspirators more than $650,000 in fraudulent claims, according to the indictment.

Marible and Jackson, neither of whom are licensed to provide mental or behavioral health services, have also been convicted. In March, Jackson was sentenced to 15 months in prison and ordered to pay $292,282 in restitution. In June, Marible was sentenced to three years and ordered to pay $1,135,662.

Earlier this month, Oriako Hampton Sowell also plead guilty to her role in a similar scheme with the three women.

Sowell also “rented out” her Medicaid provider number, prosecutors alleged. Fraudulent claims list Sowell as the attending clinician, but services were never provided. Sowell kept part of the Medicaid reimbursements and paid the rest to Jackson and Marible. Between October 2010 and April 2011, they collected at least $250,000 from Medicaid according to the indictment.

Anyone who suspects Medicare or Medicaid fraud should call 1-800-447-8477 or email at HHSTips@oig.hhs.gov.