Davidson County Women Plead Guilty to Health Care Fraud Conspiracy Involving More Than $1.1 Million

NASHVILLE, TN—Glenesha Moye, 35 and Tabitha Jones, 35, both of Nashville, pleaded guilty on June 4, 2009, to a six-count federal information in connection with a health care fraud conspiracy that cost Medicare and TennCare a combined total of more than $1.1 million, announced Edward M. Yarbrough, the United States Attorney for the Middle District of Tennessee; My Harrison, Special Agent in Charge (SAC) of the Memphis Division of the Federal Bureau of Investigation (FBI); Melody Jackson, SAC of the Department of Health and Human Services (HHS), Office of Inspector General, Office of Investigations, Atlanta Regional Office; Christopher R. Pikelis, SAC of the Internal Revenue Service (IRS) Criminal Investigations Nashville Field Office; Gordon S. Heddell, Inspector General of the United States Department of Labor and Mark Gwyn, Director of the Tennessee Bureau of Investigation (TBI).

Moye and Jones pleaded guilty before United States District Judge Aleta A. Trauger. In pleading guilty, both individuals admitted that from January 2005 through January 2008, they conspired to defraud Medicare and TennCare of more than $1.1 million. According to testimony at the plea hearing, the conspiracy and scheme to defraud involved submitting claims to Medicare and TennCare for services that were either never provided to a beneficiary or that were provided to a beneficiary by personnel not licensed by the State of Tennessee to perform the services in question. Such claims were fraudulently submitted through EBC Healthcare, a company owned and operated by Moye and Jones, who certified compliance, but knowingly failed to comply with applicable Medicare and TennCare policies. These policies required accurate identification of services by numeric identifiers commonly called “CPT Codes” and provision of services by licensed health care professionals or properly supervised, unlicensed individuals. Additionally, during the plea hearing, both Moye and Jones admitted to engaging in money laundering transactions related to the proceeds of the health care fraud scheme. Judge Trauger is scheduled to sentence both defendants in November, 2009.

“At a time when health care costs consume an ever increasing percentage of our nation’s resources, it is essential that individuals defrauding Medicare and TennCare be brought to justice,” said Yarbrough. “These guilty pleas are just one example of this office’s continuing commitment to stamping out health care fraud and abuse.”

Yarbrough praised the efforts of agencies during the course of the investigation, noting their continued commitment to work together as a team to investigate health care fraud. This investigation was conducted jointly by the FBI, HHS Office of Inspector General, IRS Criminal Investigations, DOL Office of Inspector General, and the TBI. The United States is represented by Assistant United States Attorney Matthew J. Everitt.