Mental health clinic owner guilty in $3.4 million Medicaid fraud

January 14, 2013

CHARLOTTE, N.C. – A Charlotte man pleaded guilty today for his involvement in a health care fraud scheme that attempted to defraud Medicaid of at least $3.4 million for sham mental and behavioral health services, announced Anne M. Tompkins, U.S. Attorney for the Western District of North Carolina.

U.S. Attorney Tompkins is joined in making today’s announcement by John A. Strong, Special Agent in Charge of the Federal Bureau of Investigation (FBI), Charlotte Division and Attorney General Roy Cooper, who oversees the North Carolina Medicaid Investigations Division (MID).

Ronnie Lorenzo Robinson, 36, of Charlotte, pleaded guilty today before U.S. Magistrate Judge David S. Cayer to two counts of health care fraud. At today’s plea hearing, Robinson admitted that from in or about 2007 to in or about 2011, he engaged in a scheme to defraud Medicaid of at least $3.4 million in fraudulent reimbursement payments from false claims submitted to Medicaid. According to filed court documents and statements made in court, Robinson owned and operated Peaceful Alternative Resources, Inc. (PAR), which held itself out as a non-profit provider of mental health and mentoring services and maintained offices in Charlotte, Mooresville and Greensboro, N.C. Robinson and his company defrauded Medicaid by submitting false claims to Medicaid stating that licensed clinicians allegedly employed by PAR had performed services when those clinicians had not. The claimed services, if provided at all, were provided by unlicensed individuals who were not approved by Medicaid to provide such services and, in many instances, the claimed services were not provided at all.

According to filed documents, Robinson and his company misappropriated the Medicaid provider numbers of at least three licensed clinicians who performed some work for PAR. Robinson then used these Medicaid provider numbers to seek reimbursement for services that the licensed clinicians did not perform. Court documents indicate that Robinson obtained Medicaid beneficiary information from other organizations. Although employees associated with PAR sometimes provided services to the Medicaid recipients, these services typically were not provided by licensed professionals and were little more than mentoring services, which Medicaid does not reimburse. Court documents indicate that Robinson attempted to defraud Medicaid of approximately $3.4 million and received approximately $3.1 million in payments.

During the course of the investigation, law enforcement agents seized a 2004 Land Rover Range Rover HSE, a 2007 Chevrolet Suburban, a 2007 Mercedes S550 and a 1 5/8 carat oval ladies diamond ring, purchased with money fraudulently obtained from Medicaid. Agents also seized a classic 1972 Chevrolet Chevelle-Malibu, a 2006 Chrysler 300 and approximately $660,000 in funds in connection with the fraud. Robinson has agreed to forfeit all of these assets as part of his plea.

“This type of blatant abuse of a federally-funded system simply will not be tolerated,” said U.S. Attorney Tompkins. “The money Robinson stole from Medicaid was intended to cover the medical expenses of needy North Carolinians, including children, not to fund the defendant’s penchant for cars and jewelry. My office will continue to hold accountable those who engage in schemes that rip off government health care programs supported by taxpayer dollars.”

“Health care fraud increases costs for everyone and degrades the integrity of our health care system. The FBI is committed to rooting out this type of fraud and holding those accountable who attempt to illegally manipulate the system that so many Americans count on,” said John A. Strong, Special Agent in Charge of the Charlotte Division of the FBI.

“Fraud like this hurts patients who really need care, wastes tax dollars, and drives up health care costs for everyone. Our investigators and attorneys will continue to work with their federal partners to go after health care fraud,” said Attorney General Roy Cooper, who oversees North Carolina’s MID.

At sentencing, Robinson faces a maximum term of 10 years in prison and a $250,000 fine for each count of conviction. In his plea agreement, Robinson has agreed to pay full restitution to Medicaid for any losses resulting from his criminal scheme. The final restitution amount will be determined by the Court at Robinson’s sentencing hearing, which has not been scheduled yet. Robinson remains on bond pending sentencing.

The investigation into Robinson was handled by the FBI and MID. The prosecution was handled by Assistant U.S. Attorney Kelli Ferry of the U.S. Attorney’s Office in Charlotte.

The investigation and charges are the work of the Western District’s joint Health Care Fraud Task Force. The Task Force is multi-agency team of experienced federal and state investigators, working in conjunction with criminal and civil Assistant United States Attorneys, dedicated to identifying and prosecuting those who defraud the health care system, and reducing the potential for health care fraud in the future. The Task Force focuses on the coordination of cases, information sharing, identification of trends in health care fraud throughout the region, staffing of all whistle blower complaints, and the creation of investigative teams so that individual agencies may focus their unique areas of expertise on investigations. The Task Force builds upon existing partnerships between the agencies and its work reflects a heightened effort to reduce fraud and recover taxpayer dollars.

Source: "Former Clinic Owner Pleads Guilty To $3.4 Million Medicaid Fraud Scheme," news release of the United States Attorney for the Western District of North Carolina, January 7, 2013.