(The Center Square) – More than $17 million in repayment is owed by defendants defrauding the IRS and North Carolina Medicaid, the state Department of Justice said Friday.
Five defendants in the fraud scheme have been sentenced, says first-term Democratic Attorney General Jeff Jackson. The government accountability adjudication pushes to more than $1 billion the amount the Medicaid Investigations Division has recovered in restitution and penalties.
“The people behind this scheme were supposed to help patients,” Jackson said. “Instead, they developed an elaborate scheme to steal millions in taxpayer dollars. My office and our federal partners will hold accountable anyone who exploits patients and abuses Medicaid for their personal gain.”
Kimberly Sims was sentenced to two years in federal prison and ordered to pay more than $1.8 million to Medicaid and $207,383 to the IRS. She pleaded guilty to conspiracy that included “paying illegal remunerations, committing health care fraud and making and using materially false documents, as well as filing a false tax return,” the state Justice Department said.
Last month, Keke Johnson was sentenced to six years in federal prison and order to pay Medicaid more than $15.2 million, and $331,851 to the IRS; Life Touch was sentenced to a $15 million fine, an order to dissolve, and pay $12.7 million to Medicaid; and Brandon Sims was sentenced to 2½ years in federal prison and ordered to pay $1.89 million to the IRS.
In January, Francine Super was sentenced to six years in federal prison, order to pay $15.2 million to Medicaid and $373,810 to the IRS.
More than $6 million in cash, real estate and other assets was seized.
Prosecutors said, “From 2018 to 2023, Keke Johnson and Francine Super, who worked for Life Touch, paid more than $1 million in kickbacks to Medicaid patients to incentivize them to show up for substance abuse and lab services. Johnson then billed those services to the North Carolina Medicaid program on behalf of Life Touch and 1st Choice Healthcare, a urine drug screening company, resulting in more than $12.7 million in fraudulent claims.
“The owner of 1st Choice Healthcare and Super’s daughter, Kimberly Sims, would then pay Medicaid kickbacks to the Life Touch employees for the lab services they ordered. Brandon Sims, the owner of Life Touch, received millions in proceeds from the operation, but failed to file or pay taxes on them.”
