South Raleigh News

Attorney General Josh Stein announced the sentencing of a New Hanover County health care fraud conspiracy. "When people defraud the Medicaid program, they are defrauding North Carolina’s taxpayers," said Stein. "I will continue to do everything I can to protect North Carolinians’ investment and hold perpetrators accountable. I’m proud of the Medicaid Investigations Division’s work, along with state and federal investigators and prosecutors, to stop Medicaid fraud."

Jones, a New Hanover County social worker, used her access to obtain personally identifying information for New Hanover residents enrolled in Medicaid. She then shared that information with Lakia Washington, a licensed mental health counselor. Washington used the information to submit fraudulent claims to the Medicaid program and receive reimbursements for services not provided to Medicaid recipients. The information Jones provided led to more than $400,000 in fraudulent Medicaid billing.

Washington also pleaded guilty to defrauding the Medicaid program in March 2023 and is awaiting sentencing.

This investigation arose from MID’s data mining efforts to identify and prosecute health care fraud. The case was investigated and prosecuted by the Attorney General’s Medicaid Investigations Division, the U.S. Attorney’s Office for the Eastern District of North Carolina, and the U.S. Department of Health and Human Services – Office of the Inspector General.

The Attorney General’s MID investigates and prosecutes health care providers that defraud the Medicaid program, patient abuse of Medicaid recipients, patient abuse of any patient in facilities that receive Medicaid funding, and misappropriation of any patients’ private funds in nursing homes that receive Medicaid funding.

To date, MID has recovered more than $1 billion in restitution and penalties for North Carolina. To report Medicaid fraud or patient abuse in North Carolina, call MID at 919-881-2320. MID receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $8,535,748 for Federal fiscal year (FY) 2023. The remaining 25 percent, totaling $2,845,248 for FY 2023, is funded by the State of North Carolina.