Shelby woman pleads guilty in $8M Medicaid fraud scheme

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by APRIL BETHEA / The Charlotte Observer

WCNC.com

Posted on January 4, 2013 at 10:48 PM

SHELBY, N.C. -- A Shelby woman faces federal prison time after pleading guilty Friday in a scheme that defrauded Medicaid of more than $8 million.

Victoria Finney Brewton, 37, ran a series of after-school and summer programs in Cleveland County where she recruited children by saying the services would be free for Medicaid recipients, authorities said.

Brewton and others filed papers claiming they had provided mental and behavioral health services for the children that were eligible for Medicaid reimbursements. But the services were never provided or were “little more than childcare services rendered by unqualified and unlicensed staff,” according to court papers.

Brewton was not a Medicaid provider, and was not qualified or licensed to provide the services that she sought payment for, prosecutors said. Authorities said she worked with others who were licensed – and in some cases stole the identity of Medicaid-approved providers – to fraudulently get the reimbursements.

On Friday, Brewton pleaded guilty to seven counts of health care fraud and health care fraud conspiracy, along with one count each of aggravated identity theft and filing of a false tax return.

She is out on bond while awaiting sentencing. She faces at least two years in prison for the ID theft charge. The health care fraud charges carry a maximum penalty of 10 years’ imprisonment. The false tax return charge is punishable by up to three years in prison.

Brewton also has agreed to pay a yet-to-be-determined amount of restitution and forfeit a 2005 Dodge Magnum bought using money she got in the scheme, officials said.

Brewton is the second woman convicted in the scheme. In September, Linda Smoot Radeker, a counselor from Shelby, pleaded guilty to health care conspiracy and money laundering. She also is awaiting sentencing.

Prosecutors said the fraud scheme began in 2008. Brewton ran multiple programs in Cleveland County over the years, including Healing Hearts Therapy Services, Shelby Supportive Services and Chantel’s Therapy Service, according to court papers.

As part of the scheme, officials said, Radeker agreed to file claims for services that had not been performed. Brewton and Radeker agreed to split the money received from Medicaid from the fraudulent claims, prosecutors said.

Brewton hired a licensed therapist to work for Healing Hearts. The therapist, referred to in court papers as “K.S.M.,” quit the company after learning that false paperwork had been filed using her Medicaid provider number. Brewton continued to file false claims even after “K.S.M.” left the company and also submitted a form in October 2011 asking that payments be sent to a bank account she controlled, prosecutors said.

In all, authorities said Brewton fraudulently filed in excess of $1.8 million in Medicaid claims using K.S.M.’s provider number between April 2011 and May 2012.

Brewton also admitted to filing false tax returns in 2009. Prosecutors said she also failed to file returns in 2010 and 2011 as a way to conceal the scheme.

The U.S. Attorney’s Office said the investigation of Brewton and Radeker was conducted by the Health Care Fraud Task Force that involves multiple state and federal agencies.

Officials asked anyone who suspects Medicaid or Medicare fraud to report it to federal authorities at 800-447-8477 or visit http://oig.hhs.gov. In North Carolina, suspicions about Medicaid provider fraud also can be called into 919-881-2320.

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