South Carolina Attorney General Alan Wilson announced the results of Operation Border War, a joint effort that exposed Medicaid fraud schemes totaling over $21 million. At a news conference in Charlotte, Wilson was joined by U.S. Attorney Russ Ferguson, North Carolina Attorney General Jeff Jackson, FBI Special Agent James C. Barnacle, Jr., and representatives from IRS-Criminal Investigation and the Department of Health and Human Services Office of the Inspector General.
The operation led to criminal charges against nine individuals accused of defrauding Medicaid programs in South Carolina and North Carolina. The announcement was part of a broader Justice Department initiative that charged 324 defendants with over $14.6 billion in alleged fraud.
“Medicaid fraud is theft, plain and simple,” stated Attorney General Wilson. “It robs taxpayers and puts vulnerable people at risk by draining critical resources from our healthcare system.”
Federal charges were filed against eight individuals in North Carolina’s Western District for allegedly conspiring to defraud the South Carolina Medicaid Program by submitting false claims for behavioral health services not rendered or inflated. They reportedly bought and sold personal identifying information (PII) of Medicaid beneficiaries without their knowledge.
David Corey Hill was separately charged with conspiracy to commit health care fraud and money laundering. He has agreed to plead guilty.
The indictment accuses Saunders of leading the scheme, facilitating illegal kickbacks, and helping conspirators create companies to file fraudulent claims with SC Medicaid. Others involved allegedly supported these efforts by selling PII or using licensed professionals’ National Provider Identification numbers without their consent.
During the investigation, authorities used fictitious beneficiaries to uncover fraudulent activities further. The co-conspirators are also accused of disguising kickback payments as legitimate expenses.
If convicted, defendants face significant prison time for various counts related to healthcare fraud and money laundering. All defendants are presumed innocent until proven guilty.
Suspected Medicare or Medicaid fraud can be reported at 1-800-HHS-TIPS or via email at [email protected]. Reports specific to South Carolina can be made at 1-888-364-3224.
