National Health Care Fraud Enforcement Action Results in Charges Involving over $1.4 Billion in Alleged Losses
CHARLOTTE, N.C. – A Georgia man is facing federal charges for an illegal kickback scheme that has defrauded the North Carolina Medicaid program of more than $4 million, announced William T. Stetzer, Acting U.S. Attorney for the Western District of North Carolina. Specifically, a criminal bill of information charges Glenn Pair, 35, formerly of North Carolina now residing in Georgia, with conspiracy to commit Medicaid fraud and money laundering.
“The Medicaid program provides medical services to qualified North Carolinians in need of assistance. It’s not a piggy bank for cheats and fraudsters,” said Acting U.S. Attorney Stetzer. “The U.S. Attorney’s Office will hold accountable those who engage in get-rich-schemes that exploit government programs and deprive important resources from those in real need.”
“North Carolina’s Medicaid program is meant to help the most vulnerable people in our community. Anyone who thinks they can manipulate the system should know the FBI will work tirelessly to make sure they pay dearly,” said FBI Special Agent in Charge Robert R. Wells.
“IRS Criminal Investigation is committed to unraveling complex financial transactions and money laundering schemes where individuals attempt to conceal the true source of their money. Individuals who engage in this type of financial fraud should know they will not go undetected and will be held accountable,” said Acting Special Agent in Charge Mona Passmore for the Charlotte Field Office of Internal Revenue Service Criminal Division.
As alleged in the charging document, Pair was a partner and operator of Everlasting Vitality, LLC (EV) and Do-It-4-The Hood Corporation (D4H). From January 2016 through November 2018, Pair and his co-conspirators paid individuals to recruit at-risk youths, in particular children who were Medicaid eligible, for EV’s or D4H’s after-school and youth mentoring programs. Once enrolled, children were required to submit urine specimens for drug testing. Pair and his co-conspirators allegedly conspired with certain laboratories to perform the drug testing of the enrolled children’s urine specimens submitted and received kickbacks once the laboratories were reimbursed by the North Carolina Medicaid.
Pair and his conspirators also allegedly conspired to defraud North Carolina Medicaid by providing client information used by certain laboratories to file other fraudulent reimbursement claims. For example, on some occasions, Pair and his co-conspirators obtained personal identifying information (PII) of D4H clients, such as names, addresses, dates of birth, and Medicaid beneficiary numbers, which the laboratories used to submit drug testing claims to the North Carolina Medicaid that were fraudulent because, among other reasons, the drug tests were not medically necessary, or the urine specimens were not of the Medicaid beneficiaries under whose names they were submitted. Once the laboratories were reimbursed by North Carolina Medicaid, they paid companies under the control of Pair and others a percentage of the Medicaid reimbursements.
As the bill of information alleges, the drug testing laboratories involved in the scheme submitted over $16 million in fraudulent claims to Medicaid and received $4 million in reimbursements, of which they paid more than $1.5 million in illegal kickbacks to Pair and his co-conspirators.
Pair is the second defendant charged in the scheme. Pair’s co-conspirator, Markuetric Stringfellow, was sentenced in February 2021 to 78 months in prison and was ordered pay $5,278,550 in restitution for his role in the conspiracy.
In making today’s announcement Acting U.S. Attorney Stetzer thanked the FBI, IRS-Criminal Investigations and the North Carolina Medicaid Investigations Division for their investigation of the case.
Assistant U.S. Attorney Michael E. Savage, of the U.S. Attorney’s Office in Charlotte, is prosecuting the case.
A bill of information is merely an allegation, and the defendant is presumed innocent until proven guilty beyond a reasonable doubt in a court of law.
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The Department of Justice announced today criminal charges against 138 defendants for their alleged participation in various healthcare fraud schemes that resulted in approximately $1.4 billion in alleged losses. Nationwide, the charges target approximately $1.1 billion in fraud committed using telemedicine, $29 million in COVID-19 health care fraud, $133 million connected to substance abuse treatment facilities, or “sober homes,” and $160 million connected to other health care fraud and illegal opioid distribution schemes across the country.
“This nationwide enforcement action demonstrates that the Criminal Division is at the forefront of the fight against health care fraud and opioid abuse by prosecuting those who have exploited health care benefit programs and their patients for personal gain,” said Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division. “The charges announced today send a clear deterrent message and should leave no doubt about the department’s ongoing commitment to ensuring the safety of patients and the integrity of health care benefit programs, even amid a continued pandemic.”