Charlotte Health Care Provider Convicted of Medicaid Fraud and Money Laundering
A federal jury convicted a Charlotte behavioral health care provider on Friday following a nine-day trial of defrauding the South Carolina Medicaid Program (SC Medicaid), falsely obtaining COVID-19 relief payments and money laundering.
Ashley Nicole Cross, 41, of Charlotte, was found guilty of healthcare fraud, making false statements and writings about a healthcare matter, promotional money laundering, wire fraud, and conspiracy, according to the United States Attorney’s Office for the Western District of North Carolina.
According to trial testimony, which included 25 witnesses and over 600 documents, Cross owned and operated Odyssey Health Group (OHG), a Charlotte-based corporation that was approved by SC Medicaid to offer outpatient behavioral health services to eligible Medicaid users.
Beneficiaries of SC Medicaid can access providers within 25 miles of the South Carolina border, including Charlotte. From 2016 to 2021, Cross’s company filed fraudulent payment claims with SC Medicaid and its contracted managed care organizations for rehabilitative mental health services that were never delivered. To carry out the scam, Cross exploited qualifying SC Medicaid beneficiaries’ personal identifying information (PII) to make reimbursement claims totaling $1.3 million.
In some cases, Cross purchased the PII of Medicaid beneficiaries from whom she submitted claims. To enhance the plan and provide the impression that OHG’s fraudulent claims were authentic, Cross directed OHG workers to generate bogus clinical service notes after filing fraudulent claims in the names of Medicaid recipients.
According to trial evidence, Cross was told about OHG’s Medicaid claim audits in September 2019. To conceal the crime, Cross submitted forged patient medical records and provided fraudulent statements to auditors. Cross also engaged in money laundering and utilized some of the fraudulent funds to promote the scheme by purchasing Medicaid beneficiary names and personally identifiable information (PII).
In addition to the Medicaid fraud scheme, evidence revealed that from April 3, 2020, to May 14, 2022, Cross carried out a scheme to obtain fraudulent Paycheck Protection Program (PPP) loans on behalf of OHG and Gucci International Inc. (Gucci), a fictitious event planning company owned by Cross’s boyfriend and co-conspirator.
To secure the PPP loans, Cross submitted loan applications and supporting documentation that included misleading assertions about OHG and Gucci’s payroll expenses, staff count, and other misrepresentations. Cross received about $287,000 in COVID-19 disaster payments for her enterprises and Gucci. Cross’s partner was indicted for a federal felony at the time Gucci applied for the loan.
Cross was remanded in custody after the jury returned its verdict.
Cross’s sentence will be determined by a federal district court judge based on the United States Sentencing Guidelines and other statutory circumstances. A sentencing date has not been determined.