ICYMI: Attorney General Alan Wilson announces indictments in $21 million health care fraud schemes

(COLUMBIA, S.C.) – South Carolina Attorney General Alan Wilson announced a multi-jurisdictional partnership called Operation Border War that uncovered and investigated Medicaid fraud schemes that stole more than $21 million from South Carolina taxpayers. 

Attorney General Wilson was joined at a news conference Monday in Charlotte by U.S. Attorney for the Western District of North Carolina Russ Ferguson, North Carolina Attorney General Jeff Jackson, FBI Special Agent in Charge James C. Barnacle, Jr., and representatives of IRS-Criminal Investigation and the Department of Health and Human Services Office of the Inspector General, to announce the results of the crackdown that led to criminal charges filed against nine individuals involved in separate health care fraud schemes that allegedly defrauded the South Carolina and North Carolina Medicaid Programs of millions of dollars. 

The announcement was made as part of the Justice Department’s national healthcare fraud takedown that resulted in 324 defendants being charged in connection with more than $14.6 billion in alleged fraud. 

“Medicaid fraud is theft, plain and simple. It robs taxpayers and puts vulnerable people, including children, at risk by draining critical resources from our healthcare system. My office is aggressively pursuing those who exploit the system, and we won’t stop until every dollar stolen is accounted for and every fraudster is brought to justice,” said South Carolina Attorney General Wilson. 

You can read about the cases below. 

South Carolina Medicaid Fraud Cases – U.S. v. Saunders et al. & U.S. v. Hill 

Federal criminal charges were filed in the Western District of North Carolina against eight individuals who allegedly conspired to defraud the South Carolina Medicaid Program (SC Medicaid) of more than $21 million by filing false and fraudulent reimbursement claims for behavioral health care services that were either inflated or not provided at all. It is alleged that these individuals bought and sold personal identifying information (PII) of SC Medicaid beneficiaries, and submitted reimbursement claims for patients who never knew their information was being used and never received the services. 

The seven individuals charged with conspiracy to commit health care fraud and to pay and receive illegal kickbacks are: 

• Donald Calvin Saunders, 62, of Charlotte. Saunders is also charged with six counts of health care fraud; one count of unlawful purchase of beneficiary identification numbers; one count of conspiracy to commit money laundering; and three counts of money laundering. 

• Vanessa Ragin-Boatright, 59, of Manning, South Carolina. Boatright is also facing two counts of health care fraud; one count of unlawful purchase of beneficiary identification numbers; and one count of conspiracy to commit money laundering. 

• Dajuan Strickland, 47, of Charlotte and Buffalo, New York. Strickland is also charged with three counts of health care fraud; two counts of unlawful purchase of beneficiary identification numbers; one count of conspiracy to commit money laundering; and three counts of money laundering.
• Cynthia Jenkins Harris, 60, of Elgin, South Carolina. Harris is also facing one count of health care fraud and one count of conspiracy to commit money laundering. 
• Latarsa Hitchcock, 56, of Jacksonville, North Carolina.
• Stephanie Corbett, 59, of Jonesboro, Georgia.
• Karen McClary, 51, of Kingstree, South Carolina.

David Corey Hill, age 54, of Concord, North Carolina, who was also part of the scheme, was charged separately via a criminal bill of information with conspiracy to commit health care fraud and money laundering. Hill has agreed to plead guilty and is expected to appear in federal court for a plea hearing in the days ahead. 

According to allegations contained in charging documents and other court records, from 2017 to 2024, the defendants conspired with each other and others to defraud the SC Medicaid program by submitting false and fraudulent reimbursement claims for behavioral health services that were not rendered as claimed and were tainted by illegal kickbacks and bribes. To carry out the scheme, the co-conspirators allegedly filed thousands of fraudulent claims using a network of companies in the Charlotte area and elsewhere. SC Medicaid beneficiaries are permitted to receive behavioral health services from qualified North Carolina providers located within a 25-mile radius of the South Carolina border. 

The indictment alleges that Saunders was an organizer and leader of the scheme to defraud SC Medicaid and to pay and receive illegal kickbacks and bribes for Medicaid beneficiary names and identification numbers used to facilitate the scheme. As the leader of the conspiracy, Saunders allegedly helped other conspirators, including Hitchcock, Strickland, and Hill, create and operate billing companies or companies that provided behavioral health care services used to file fraudulent reimbursement claims with SC Medicaid. In exchange, Saunders received a portion of the illegal proceeds generated by those companies. Other individuals in the conspiracy, including Jenkins, McClary, and Corbett, supported the scheme by selling the PII of SC Medicaid beneficiaries; suppling licensed behavioral health professionals’ National Provider Identification (NPI) numbers; creating fictitious service notes for SC Medicaid beneficiaries who purportedly received services; or submitting fraudulent claims to SC Medicaid for reimbursement. 

The indictment alleges that the beneficiaries whose names and PII were purchased and sold did not know that Medicaid claims had been submitted in their name and did not receive the services as represented to SC Medicaid. 

In addition to using stolen PII of SC Medicaid beneficiaries, during the investigation, the South Carolina Attorney General’s Vulnerable Adults and Medicaid Provider Fraud unit (SAG VAMPF), with the Assistance of the South Carolina Department of Health and Human Services (SCDHHS), created fictitious Medicaid beneficiaries, which they then sold to the co-conspirators. 

The indictment alleges that the co-conspirators used the fictitious beneficiaries’ numbers to file fraudulent reimbursement claims with SC Medicaid for services that were never rendered. 

It is further alleged that the co-conspirators paid bribes and illegal kickbacks to other individuals involved in the scheme, including providers who allowed the defendants to use their NPIs in connection with the filing of fraudulent claims. However, according to the indictment, many of the NPIs used by the co-conspirators belonged to professionals who were not part of the scheme but were tricked into providing their NPIs and credentials to the co-conspirators as part of an application for a job that never materialized. In the state of South Carolina, rendering providers of mental health services are licensed by the South Carolina Department of Labor, Licensing and Regulations (LLR), and most are licensed independent practitioners. 

The indictment alleges that the defendants were collectively paid over $21 million as a result of the health care fraud scheme. It is further alleged that the defendants engaged in a money laundering conspiracy and conducted financial transactions designed to conceal and disguise the nature and source of the payments. For example, it is alleged that kickback agreements and payments were disguised as consulting contracts, payroll, and other seemingly legitimate expenses. 

If convicted, the defendants face a maximum statutory sentence of five years in prison on the healthcare fraud conspiracy count, ten years in prison on the healthcare fraud counts, twenty years in prison on the money laundering conspiracy count, and ten years in prison on the money laundering counts. Ultimately, their sentences will be determined by the Court based on the advisory sentencing guidelines and other statutory factors. 

An indictment or information is merely an allegation. All defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.  

If you suspect Medicare or Medicaid fraud, please report it by phone at 1-800-HHS-TIPS (1-800-447-8477) or via email at [email protected]. 

To report suspected Medicaid fraud in South Carolina, contact the South Carolina Department of Health and Human Services via the toll-free tip line at 1-888-364-3224. 

TRICARE fraud can be reported here. 

Fraud against the U.S. Department of Veterans Affairs healthcare system can be reported at www.vaoig.gov/hotline.