CHARLOTTE, N.C. (QUEEN CITY NEWS) – A Charlotte behavioral health services provider has been indicted on federal charges for allegedly defrauding the South Carolina Medicaid program and falsely obtaining COVID-19 relief funds.
The U.S. Attorney’s Office said Wednesday the 16-count federal indictment charges Ashley Nicole Cross, 41, of Charlotte, with health care fraud, making false writings relating to a health care matter, making false statements relating to a health care matter, promotion money laundering, wire fraud, wire fraud conspiracy and wire fraud affecting a financial institution.
The health care fraud scheme
The indictment alleges that Cross owned and operated Odyssey Health Group (OHG), a Charlotte-based company that was enrolled with S.C. Medicaid and provided outpatient behavioral health services to eligible Medicaid beneficiaries in South Carolina
From 2016 to 2021, Cross reportedly carried out an extensive health care fraud scheme involving the submissions of fraudulent reimbursement claims to S.C. Medicaid and its contracted managed-care organizations for services that were never provided.
Records show filed Odyssey Health Group Inc. as an LLC in 2015, with offices Uptown on North Tryon Street.
The indictment alleges that Cross paid for the personal identifying information of qualified S.C. Medicaid beneficiaries.
Cross then allegedly used the PII to file fraudulent reimbursement claims totaling at least $400,000. To further the scheme and to give the appearance that OHG’s fraudulent claims were legitimate, Cross allegedly instructed OHG employees to create fictitious patient files and clinical service notes in the names of beneficiaries.
The COVID-19 fraud scheme
According to allegations in the indictment, from April 3, 2020, to May 14, 2022, Cross executed a scheme to obtain fraudulent Paycheck Protection Program loans on behalf of OHG and Gucci International Inc. (Gucci), a purported event planning business owned by a co-conspirator.
To obtain the PPP loans, Cross submitted loan application and supporting documents that contained false statements regarding OHG’s and Gucci’s payroll expenses, number of employees and other misrepresentations. As a result of the fraudulent PPP loan applications and supporting documents, Cross and her co-conspirator reportedly obtained more than $120,000 in COVID-19 relief funds for OHG and Gucci. At the time of Gucci’s loan application, the company’s owner was under indictment for a federal offense.
The attorney’s office said a summons has been issued, and Cross will appear in federal court for her initial appearance. Here are the maximum penalties for each offense:
- Health care fraud: 10 years in prison
- Making false writings and false statements relating to a health care matter: five years
- Promotion money laundering and wire fraud: 20 years per count
- Wire fraud conspiracy affecting a financial institution: 30 years
Assistant U.S. Attorney Michael E. Savage of the U.S. Attorney’s Office in Charlotte is prosecuting the case.
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