Mental Health Counselor Receives Six-Year Prison Sentence for Defrauding Medicaid of $6.1 Million
Defendant Used Proceeds to Purchase $500,000 in Jewelry and Vehicles
|U.S. Attorney’s Office August 08, 2013|
CHARLOTTE, NC—A mental health counselor who admitted overseeing a health care scheme that defrauded Medicaid of at least $6.1 million for sham mental and behavioral health services was sentenced to 72 months in prison today, announced Anne M. Tompkins, U.S. Attorney for the Western District of North Carolina. Linda Smoot Radeker, 72, of Shelby, North Carolina, was also sentenced to serve two years under court supervision and to pay $6,156,674.68 as restitution to Medicaid.
U.S. Attorney Tompkins is joined in making today’s announcement by Attorney General Roy Cooper, who oversees the North Carolina Medicaid Investigations Division (MID); John A. Strong, Special Agent in Charge of the Federal Bureau of Investigation (FBI), Charlotte Division; Jeannine A. Hammett, Special Agent in Charge of the Internal Revenue Service, Criminal Investigation (IRS-CI); and Derrick Jackson, Special Agent in Charge, Department of Health and Human Services, Office of the Inspector General (HHS-OIG), Office of Investigations, Atlanta Region.
In September 2012, Radeker pleaded guilty to one count of health care fraud conspiracy and two counts of money laundering. In her plea agreement filed with the court, Radeker admitted that from 2008 to 2011 she obtained at least $6.1 million in fraudulent reimbursement payments from false claims submitted to Medicaid. According to filed court documents and today’s sentencing hearing, Radeker, a licensed professional counselor enrolled with North Carolina Medicaid, falsely claimed in billings submitted to Medicaid that she was the attending clinician for services provided to Medicaid recipients, when no such services were provided. Court records show that Radeker “rented out” her Medicaid provider number to a network of co-conspirators operating in Gaston and Cleveland Counties and elsewhere and, in return, kept a percentage of the fraudulent Medicaid reimbursements, sometimes as much as 50 percent.
Court records show that the co-conspirators used on the fraudulent claims primarily the Medicaid numbers of children whose parents thought were being enrolled in after school programs located in Shelby, Kings Mountain and Bessemer City, North Carolina. These after school programs were, in fact, owned and operated by Radeker’s co-conspirators.
According to court documents, Radeker made several large purchases using criminal proceeds including $21,500 to purchase a 2010 Ford Ranger and $44,440 to purchase a 2010 Lincoln MKS SUV. Radeker also used Medicaid money to purchase a recreational vehicle (RV) and at least $500,000 in jewelry.
In making today’s announcement, U.S. Attorney Tompkins stated, “Health care fraud harms all of us—government programs, private insurers, health care providers, and individual patients. We remain committed to finding and prosecuting those who steal from important health care programs and putting a stop to the egregious assault of precious health care resources.”
North Carolina Attorney General Roy Cooper said, “This type of fraud hurts patients who really need care, wastes taxpayers’ money, and drives up health care costs for all of us. Our investigators and attorneys will continue to work with their federal partners to find and root out Medicaid cheaters.”
“Instead of assisting North Carolina families in need, Linda Radeker exploited them, using their Medicaid benefits to file false claims for her own profit. Today’s sentencing should be a warning to those who abuse their position of trust within the medical community, the FBI and our law enforcement partners will investigate and prosecute such fraud to the fullest extent of the law,” said John A. Strong, Special Agent in Charge, FBI Charlotte.
“The state’s Medicaid program is intended to serve those in need—not purchase luxury vehicles for criminals at taxpayer expense,” said Derrick L. Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General for the region including North Carolina. “Along with our law enforcement partners, we will ferret out and prosecute those defrauding our government health programs.”
“This is a very serious matter because health care fraud damages everyone,” said Jeannine A. Hammett, Special Agent in Charge, IRS-Criminal Investigation. “Ms. Radeker received money she was not entitled to and she created false documents to hide the true nature of the funds.”
In sentencing the defendant, U.S. Chief District Judge Frank D. Whitney noted that “health care costs have been skyrocketing” and that “legitimate providers like [Radeker] ... take scarce resources and stretch them even further” through theft and fraud. Judge Whitney observed that this was a “glaring example of health care fraud” where Radeker “personally pocketed in excess of $3 million.” In announcing the six year sentence, Judge Whitney stated that we have to make it clear that we trust health providers and that the trust placed on the individual is critical. Radeker breached that trust and the message has to be sent to others.
Radeker will be ordered to report to the Federal Bureau of Prisons upon designation of a federal facility. All federal sentences are served without the possibility of parole.
The investigation into Radeker was handled by the FBI, MID, IRS, and HHS-OIG. Special assistance to the task force was provided by the North Carolina Division of Medical Assistance, Program Integrity Section. The prosecution was handled by Assistant U.S. Attorneys Kelli Ferry and Jenny Grus Sugar of the U.S. Attorney’s Office in Charlotte.
The investigation and charges are the work of the Western District’s joint Health Care Fraud Task Force. The task force is multi-agency team of experienced federal and state investigators, working in conjunction with criminal and civil Assistant United States Attorneys, dedicated to identifying and prosecuting those who defraud the health care system, and reducing the potential for health care fraud in the future. The task force focuses on the coordination of cases, information sharing, identification of trends in health care fraud throughout the region, staffing of all whistle blower complaints, and the creation of investigative teams so that individual agencies may focus their unique areas of expertise on investigations. The task force builds upon existing partnerships between the agencies and its work reflects a heightened effort to reduce fraud and recover taxpayer dollars.
If you suspect Medicare or Medicaid fraud please report it by phone at 1-800-447-8477 (1-800-HHS-TIPS), or e-mail at HHSTips@oig.hhs.gov.