Woman guilty of Medicare fraud

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by Charlotte Observer Staff

WCNC.com

Posted on February 11, 2013 at 10:51 PM

CHARLOTTE, N.C. -- A Charlotte woman has been convicted in federal court in Charlotte of a Medicare fraud scheme that cost the government at least $650,000, prosecutors say.

Charlotte Elizabeth Garnes, 37, was accused of participating in a scheme for two years to submit claims for Medicare counseling services that never were performed.

Two other women who were part of the scheme, Teresa Marible and Michele Jackson, were convicted earlier in the case.

Prosecutors alleged that Garnes, a licensed professional counselor who was approved by Medicare to provide mental and behavioral health services, conspired with Marible and Jackson, who were not licensed, to submit claims under Garnes’ name and provider number.

Federal prosecutors said during the trial that Garnes kept 30 percent of the fraud proceeds and distributed the rest to her co-conspirators. From March 2009 to April 2011, according to prosecutors, Medicaid paid Charlotte’s Insight Inc., which was identified as Garnes’ company, about $740,000. About 90 percent of that, the government said, was based on false claims for services that Garnes did not provide.

A number of Medicaid recipients testified during the weeklong trial, which ended Friday, that they or their children never received the therapy services that Garnes claimed to have provided.

In fact, prosecutors said, Garnes was not in North Carolina or in the United States when some of the claimed services were performed.

Evidence submitted during the trial also showed that Garnes routinely billed for more than 24 hours of therapy services in a single day. For one day in December 2009, the government claimed, Garnes submitted claims for 69 hours of services.

Prosecutors claimed Garnes used some of the money she received to buy a Mercedes and for plastic surgery.

She was convicted on all 12 counts against her and has been released on bond. She faces up to 35 years in prison and a fine of up to $750,000. A sentencing hearing has not been scheduled.

Marible was sentenced last June to 36 months in prison and ordered to pay $1.135 million in restitution. Jackson was sentenced last March to 15 months in prison and ordered to pay more than $292,000 in restitution.

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