Home Memphis Press Releases 2009 Nashville Woman Indicted by Federal Grand Jury in $1.1 Million Health Care Fraud Scheme
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Nashville Woman Indicted by Federal Grand Jury in $1.1 Million Health Care Fraud Scheme

U.S. Attorney’s Office August 13, 2009
  • Middle District of Tennessee (615) 736-5151

NASHVILLE, TN—Edward M. Yarbrough, 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 and Mark Gwyn, Director of the Tennessee Bureau of Investigation (TBI) announced that Candyce Jones, 34, of Nashville, Tennessee, was indicted Wednesday by a federal grand jury in Nashville on eight counts of health care fraud, in violation of Title 18, United States Code, Sections 1347(1) & (2), money laundering, in violation of Title 18, United States Code, Section 1957, and two counts of aggravated identity theft, in violation of Title 18, United States Code, Section 1028A(a)(1) & 2.

According to the indictment, Jones owned and operated Merrilee Healthcare (“Merrilee”), a limited liability company that operated in the Middle District of Tennessee. Merrilee was both a Medicare Provider and TennCare Participating Provider engaged primarily in the business of submitting claims to Medicare and TennCare for services purportedly provided to Medicare beneficiaries and TennCare beneficiaries living in Davidson County, Tennessee. Through Merrilee, Candyce Jones regularly caused claims to be submitted to, and received payments from, Medicare and TennCare. The indictment alleges as part of the scheme, that, beginning in or about March 2005, and continuing thereafter until in or about February 2008, Candyce Jones, through Merrilee, caused fraudulent claims, in excess of approximately $1,100,000, to be submitted to Medicare and TennCare for psychotherapy and other services that either were never provided or were provided by unlicensed individuals.

The indictment further alleges that on or about December 19, 2007, Candace Jones withdrew funds, which had been illegally obtained through the health care fraud scheme, in the amount of $86,013 from a Bank of America account, obtained a cashier’s check for the same amount and used the check to purchase real estate in Nashville.

Also alleged in the indictment is the fraudulent use by Jones of a purported beneficiary’s social security number and the fraudulent use of a doctor’s provider identification number when submitting the fraudulent claims.

Jones was arrested this morning by federal agents and is expected to make an initial appearance this afternoon before U.S. Magistrate Judge E. Clifton Knowles. If convicted, Jones faces a maximum of 12 years in prison.

This case is being investigated by agents of the FBI, TBI, HHS-OIG and the IRS-Criminal Investigation. Assistant United States Attorney Matthew J. Everitt is representing the United States.

The public is reminded that an indictment is merely an allegation. The defendant is presumed innocent until and unless proven guilty.

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