Charleston, South Carolina---- Following a four-day trial before U.S. District Judge Richard Gergel, a federal jury convicted Gena Randolph, 44, of Mount Pleasant, of committing a $2 million health care fraud scheme, announced United States Attorney Sherri A. Lydon.
Randolph was convicted of one count of Health Care Fraud, one count of Aggravated Identity Theft, and four counts of Making False Statements Relating to Health Care Matters. Randolph could be sentenced up to 10 years in federal prison on the Health Care Fraud count and up to five years on the False Statement counts, which will be in addition to a mandatory sentence of two years for the count of Aggravated Identity Fraud.
According to evidence presented at trial, Randolph was excluded from Medicaid and Medicare after her 2012 conviction for Filing False Claims with the South Carolina Medicaid Program. As an excluded person, she was prohibited from working for any provider to perform services paid for, in whole or in part, by Medicare and Medicaid.
Over the course of the trial, the Government presented evidence showing that Randolph disguised her ownership and control over Palmetto Speech and Language Associates and Per Diem Healthcare Services, both of which were submitting claims to Medicare and Medicaid. As part of the health care fraud scheme, Randolph submitted claims both for speech therapy services that either were provided by other speech therapists and for services that were never rendered at all. In addition to hearing from the speech therapists in whose names Randolph submitted fraudulent claims, the jury was presented with evidence showing that Randolph submitted claims for services to beneficiaries who were dead.
U.S. Attorney Lydon stated, “This case is a great example of the coordinated efforts of the South Carolina Attorney General’s office and the U.S. Attorney’s office to combat health care fraud. Cases like this send the message to all health care providers that we are committed to stamping out fraud in our state."
"It is reprehensible that one would steal from federal health care programs intended to serve our country’s most vulnerable population," said Derrick Jackson, Special Agent in Charge for the Department of Health and Human Services Office of Inspector General. “We will continue to work with our law enforcement partners to bring these criminals to justice."
The case was investigated by Special Investigator Chris Radcliff of the Medicaid Fraud Control Unit of the South Carolina Attorney General’s office and Special Agent Chris Lott with the United States Department of Health and Human Services - Office of Inspector General. The case was prosecuted by Nancy Cote, Senior Assistant Deputy Attorney General and Director of the Medicaid Fraud Control Unit, and Assistant United States Attorney Matt Austin of the Charleston office. ##
Source: U.S. Department of Justice, Office of the United States Attorneys
