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Defendant“Rented Out” Her Provider Number and Used Proceeds to Purchase $500,000 inJewelry and Vehicle
CHARLOTTE, NC—A Shelby woman pleadedguilty in U.S. District Court today for her involvement in a health care fraudscheme that defrauded Medicaid of at least $6.1 million for sham mental andbehavioral health services, announced Anne M. Tompkins, U.S. Attorney for theWestern District of North Carolina.
U.S. Attorney Tompkins is joined inmaking today’s announcement by Attorney General Roy Cooper, who oversees theNorth Carolina Medicaid Investigations Division (MID); Chris Briese, SpecialAgent in Charge of the Federal Bureau of Investigation (FBI), CharlotteDivision; Jeannine A. Hammett, Special Agent in Charge of the Internal RevenueService, Criminal Investigation (IRS-CI); and Derrick Jackson, Special Agent inCharge, Department of Health and Human Services, Office of the InspectorGeneral (HHS-OIG), Office of Investigations, Atlanta Region.
Linda Smoot Radeker, 61, of Shelby,North Carolina, pleaded guilty today before U.S. Magistrate Judge David S.Cayer to one count of health care fraud conspiracy and two counts of moneylaundering. At today’s plea hearing, Radeker admitted that from 2008 to 2011she obtained at least $6.1 million in fraudulent reimbursement payments fromfalse claims submitted to Medicaid. According to filed court documents andstatements made in court, Radeker, a licensed professional counselor enrolledwith North Carolina Medicaid, claimed in the fraudulent Medicaid billings thatshe was the attending clinician for these provided services, when, in fact, sheprovided no services to the claimed beneficiaries. Court records indicate thatRadeker oversaw a network of co-conspirators, operating in Gaston and ClevelandCounties and elsewhere, who billed for false and fraudulent claims throughRadeker’s provider number. In exchange for her willingness to “rent out” herMedicaid provider number, Radeker kept a percentage of the Medicaid reimbursements,sometimes as much as 50 percent.
Filed documents also indicate that theclaimed Medicaid beneficiaries primarily were children recruited from thecommunity, whose parents thought they were enrolling in after school programsowned and operated by Radeker’s co-conspirators and located in Shelby, KingsMountain, and Bessemer City, North Carolina. Through those programs, Radekerand her co-conspirators obtained the children’s Medicaid information which theyused to file the fraudulent claims.
According to court documents, Radekermade several large purchases using criminal proceeds including $21,500 topurchase 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 atleast $500,000 in jewelry.
In announcing today’s guilty plea, U.S.Attorney Tompkins said, “Radeker’s criminal conduct is an assault on healthcare resources meant to cover the needs of the poor, the sick and the elderly.In 2010, we formed the Western District of North Carolina Health Care FraudTask Force to target criminals and illegal schemes like Radeker’s. I am proudof the work of the task force and the continued commitment of our federal,state, and local partners in identifying and prosecuting those who compromisethe integrity of a health care system that provides much needed services tovulnerable North Carolinians.”
North Carolina Attorney General RoyCooper stated, “Medicaid cheaters waste taxpayer money and drive up medicalcosts for everyone. We’ll continue our strong partnership with federal lawenforcement to root out fraud and abuse in our health care system.”
“Radeker’s scheme targeted some of themost vulnerable families in North Carolina. She betrayed parents dependent onMedicaid for their children’s care. Health care fraud not only poses apotential risk to patients, it increases costs for everyone,” said FBI SpecialAgent in Charge Chris Briese.
IRS-CI Special Agent in Charge Hammettstated, “The abuse and misuse of Medicaid Programs impacts each of us astaxpayers and citizens. IRS-CI will continue to work jointly with the UnitedStates Attorney’s Office and other law enforcement agencies to ferret out thosewho might consider Medicaid fraud as a way to make easy money.”
At sentencing, Radeker faces a maximumterm of 10 years in prison and a $250,000 fine for the health care fraudconspiracy charge, and a maximum term of 10 years in prison and a $250,000 fineor twice the value of the transaction for each count of money laundering. Inher plea agreement, Radeker has agreed to pay full restitution to Medicaid forany losses resulting from her criminal scheme. The final restitution amountwill be determined by the court at Radeker’s sentencing hearing, which has notbeen scheduled yet.
The investigation into Radeker washandled by the FBI, MID, IRS, and HHS-OIG. Special Assistance to the task forcewas provided by the North Carolina Division of Medical Assistance, ProgramIntegrity Section. The prosecution was handled by Assistant U.S. AttorneysKelli Ferry and Jenny Grus Sugar of the U.S. Attorney’s Office in Charlotte.
The investigation and charges are thework of the Western District’s joint Health Care Fraud Task Force. The taskforce is multi-agency team of experienced federal and state investigators,working in conjunction with criminal and civil Assistant United StatesAttorneys, dedicated to identifying and prosecuting those who defraud thehealth care system, and reducing the potential for health care fraud in thefuture. The task force focuses on the coordination of cases, informationsharing, identification of trends in health care fraud throughout the region,staffing of all whistle blower complaints, and the creation of investigativeteams so that individual agencies may focus their unique areas of expertise oninvestigations. The task force builds upon existing partnerships between theagencies and its work reflects a heightened effort to reduce fraud and recovertaxpayer dollars.
If you suspect Medicare or Medicaidfraud, please report it by phone at 1-800-447- 8477 (1-800-HHS-TIPS), or E-Mailat HHSTips@oig.hhs.gov.
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