top of page
Writer's pictureAllegiant Experts

Two Carolina Women In Hot Water For Defrauding Health Insurance Programs

You would think that just about everyone who decides to enter the professional world of medicine would do so with good intentions. Sure, many jobs in the medical field often pay pretty well. But, there’s also got to be that feeling of accomplishment and pride in knowing that your job is one that helps people. Restoring health for the injured and the sick is a noble act, let alone a prestigious occupation. And this is what makes it so heartbreaking when such an occupation is abused.

This is the case with Christine Hicks Thomas of Murfreesboro, North Carolina. The 62-year old nurse practitioner pleaded guilty to Illegal Remunerations in court last week. According to a report from the United States Department of Justice’s Eastern District of North Carolina branch, Thomas admitted to receiving kickbacks for signing orders for Medicaid services. Evidently, helping the hurt and the sick wasn’t enough for Thomas.

The report, published last Wednesday, reveals that she agreed to sign off on orders that authorized a number of Medicaid recipients to receive outpatient behavioral health services. Thomas, however, never actually evaluated any of the patients or made any clinical assessments to determine whether or not the services were even needed. Evidence submitted into court included a recording of Thomas accepting a cashier’s check in exchange for signing the orders.

“The orders that Thomas signed are required by Medicaid’s Managed Care Organizations as a prerequisite before a Medicaid provider can bill the government for outpatient behavioral health services,” the report explains, “Once authorization orders are signed, providers can lawfully bill the government for hundreds of thousands of dollars in outpatient behavioral health services, provided such services are actually rendered.”

As a result of her guilty plea, Thomas now faces up to five years in prison, $25,000 in fines and three years of supervised release. In addition, she has to surrender her nursing license as well as any interest she has in companies that bill the government for health care services. She must also be permanently excluded from Medicare and Medicaid programs. Needless to say, Thomas is no longer a licensed nurse practitioner.

Not to be outdone by Thomas is 41-year old Felicia L. Prysock of Wellford, South Carolina. Last Wednesday, The United States Department of Justice’s District of South Carolina branch reported that she has been charged with a 30-count indictment that includes aggravated identity theft, false statements related to health matters and obtaining a controlled substance by fraud.

“The indictment alleges that Prysock filled ten different prescriptions forged in the names of her children and had Medicaid pay for them,” says the report, “The conduct occurred between July 2016 and April 2017. The investigation revealed that these prescriptions were for Schedule II opioids, such as oxycodone, hydrocodone, and Adderall.”

One of the scariest things pointed out by the report is the high rate of deaths in the United States caused by opioids. A White House press release revealed that hundreds of Americans are dying on a daily basis because of opioid overdoses. Prysock’s actions, of course, only serve to grow that number.

If you’re an attorney who is trying a case that involves health insurance fraud, please don’t hesitate to contact the clinical experts at Allegiant Experts to learn how we may be able to help you. Give us a call at 407-217-5831 or email us at info@allegiantexperts.com.

4 views0 comments

Comments


bottom of page