A North Carolina man has been sentenced to five years in prison, followed by two years of supervised release, for his role in a scheme that stole millions from Medicaid. Jerry Taylor was found guilty of defrauding Medicaid as well as federal tax evasion.
His co-conspirator, Ameera Ali, of Columbus, Ohio, was sentenced to seven years in prison with one year of supervised release for her role in the scheme. The ringleader, Tony Taylor of Brooklyn, N.Y., was sentenced to eight years in prison with two years of supervised release. (Looks like Jerry was just following in his older brother’s footsteps.)
From June 2015 to December 2017, Jerry Taylor and his brother Tony worked together to defraud Medicaid out of more than $9.4 million by submitting fraudulent reimbursement claims. The claims submitted were for services that were non-existent or only partially reflective of the services provided. (Fraudsters always think no one will notice a “little” padded billing.)
The brothers submitted claims through four companies they owned and operated in North Carolina. These companies were licensed to provide outpatient behavioral health services to at-risk youths. The limited behavioral services provided to their young patients were delivered by someone who did not possess the proper credentials to do so. (Go figure. It’s a common fraud scheme.)
Jerry Taylor was responsible for managing the submission of fraudulent claims for their companies. These bogus claims were submitted through a third-party billing company owned by Ameera Ali. Ali provided billing services knowing that the majority of claims sent to Medicaid were fraudulent. She also provided Tony Taylor with potential patients who were Medicaid beneficiaries. (Every good villain has a sidekick.)
Together, the Taylor brothers and Ali charged Medicaid beneficiaries for services they had never provided. Some of the claims were for services that had been provided, but were billed at a higher reimbursement rate. (This practice is known as “upcoding,” a common type of Medicaid fraud.)
Tony Taylor instructed the director of one of their companies, Devon Rambert-Hairston, to use her position as a licensed nurse practitioner to sign off on fictitious patients’ records and progress reports. Rambert-Harrison never provided behavioral health services to Medicaid beneficiaries. (Go figure.) Fictitious progress reports, treatment notes, and fake billing spreadsheets were created by Christine Knight, who owned Move Staffing LLC in Florida.
Jerry and Tony Taylor were responsible for hundreds of fraudulent claims to the North Carolina Medicaid program. Over $9.4 million fraudulent claims were submitted, resulting in a loss of more than $6.1 million to Medicaid.
Jerry Taylor was also found guilty of tax evasion. He failed to file accurate tax returns for 2016 and 2017 by not reporting over $1.6 million in reimbursements, which he diverted to other entities. Jerry Taylor then used the entities he owned to hide the money, which he eventually spent on travel and medical expenses.
In addition to Jerry Taylor’s five-year prison sentence, he was also ordered to pay more than $6.1 million to North Carolina Medicaid and over $346,000 to the U.S. Internal Revenue Service as restitution. (Seems justified that he lost the millions he wasn’t entitled to in the first place.)
Devon Rambert-Hairston was previously sentenced to a year and a day in prison and a year of supervised release. She was also ordered to pay $813,726 in restitution. Christine Knight pleaded guilty to making a false statement relating to health care matters and is awaiting sentencing. (We all know how this is going to go. Who knows, maybe she and Devon will be cellmates.)
If you suspect Medicare or Medicaid fraud please report it by phone at 1-800-447-8477 or via email at HHSTips@oig.hhs.gov.
Today’s Fraud of the Day comes from a Department of Justice press release, “North Carolina Man Is Sentenced To Prison For Conspiring To Steal Millions From Medicaid,” dated October 22, 2020.
CHARLOTTE, N.C. – Today, U.S. District Judge Robert J. Conrad Jr. sentenced Jerry Lewis Taylor, 55, of Wingate, N.C., to five years in prison followed by two years of supervised release, for conspiring to steal millions from Medicaid and committing tax evasion, announced Andrew Murray, U.S. Attorney for the Western District of North Carolina. In addition to the prison term imposed, Jerry Taylor was also ordered to pay more than $6.1 to North Carolina Medicaid and over $346,000 to the U.S. Internal Revenue Service as restitution.
On Tuesday, October 20, 2020, Jerry Taylor’s co-conspirator, Ameera Ali, 41, of Columbus, Ohio, was sentenced to 84 months in prison and one year of supervised release, for her role in the scheme. In July 2020, the leader of the scheme, Tony Garrett Taylor, 40, of Brooklyn, N.Y., was sentenced to 96 months in prison and two years of supervised release.