Leader Of $6.1 Million Medicaid Fraud Scheme Pleads Guilty To Federal Charges

CHARLOTTE, N.C. – PRESS RELEASE -- U.S. Attorneys » Western District of North Carolina Oct 31, 2019 

Tony Garrett Taylor, 39, formerly of Charlotte, N.C. and currently residing in Atlanta, Georgia, pleaded guilty today to health care fraud conspiracy and tax evasion, for his role in a scheme that defrauded the North Carolina Medicaid (Medicaid) of more than $6.1 million, announced Andrew Murray, U.S. Attorney for the Western District of North Carolina.  U.S. Magistrate Judge David S. Cayer presided over the plea hearing. 

North Carolina Attorney General Josh Stein, who oversees the North Carolina Medicaid Investigations Division (MID), joins U.S. Attorney Murray in making today’s announcement.

According to the bill of information and plea documents filed with the court, from June 2015 to December 2017, Tony Garrett Taylor conspired with his brother, Jerry Lewis Taylor, and others, and defrauded Medicaid of millions of dollars, by submitting fraudulent reimbursement claims for services that were never provided, and by submitting claims that misrepresented the services actually provided to Medicaid beneficiaries in order to receive greater reimbursement. 

Court documents show that the brothers perpetuated the fraud through series of entities they owned and/or operated, which purported to provide outpatient behavioral health services to at-risk youth in North Carolina and elsewhere.  Among the entities involved in the fraudulent scheme were Taylor Behavioral Health Center, LLC (TBHC) and Options Drive LLC, both located in Monroe, N.C.; Design for Change (DFC) located in Raleigh, N.C.; and SHG Consultants, Inc. (SHG), located in Gastonia, N.C. and elsewhere.

According to court documents, as the leader of the conspiracy, Tony Taylor was responsible for recruiting other co-conspirators to participate in the fraudulent scheme. He also obtained prospective patient lists that contained identifying information for Medicaid beneficiaries, some of which was used to perpetrate the fraud. As a result of the fraudulent scheme, Tony Taylor and Jerry Taylor and their co-conspirators received approximately $6.1 million in fraudulent reimbursement payments from Medicaid.

In addition to defrauding Medicaid, Tony Taylor also failed to file timely U.S. individual Income Tax Return Form 1040 for tax years 2015, 2106, and 2017, even though he received and deposited a total of over $4.1 million in fraudulent receipts from Medicaid into bank accounts he controlled.  Tony Taylor also admitted to taking steps to willfully evade and defeat his income tax obligations for tax years 2015, 2016, and 2017, by, among other things, diverting fraudulent receipts from Medicaid to nominee entities and individuals, and making personal expenditures from business entity accounts he controlled. 

To date, four other defendants have been charged in connection with this conspiracy:

Jerry Lewis Taylor, 54, of Wingate, N.C. pleaded guilty on June 19, 2019, to health care fraud conspiracy and tax evasion. Together with Tony Taylor, he owned and/or operated entities that defrauded Medicaid.  He is currently awaiting sentencings.

Ameera Ali, 40, of Columbus, Ohio, previously admitted to filing fraudulent reimbursement claims with Medicaid on behalf of companies owned and operated by Tony Taylor, Jerry Taylor and others.  She pleaded guilty on April 22, 2019, to health care fraud conspiracy and is currently awaiting sentencing.

Devon Rambert-Hairston, 41, of Huntersville, N.C. and a licensed as a nurse practitioner, previously admitted to falsifying patient records used by Tony Taylor and Jerry Taylor to submit fraudulent reimbursement claims to Medicaid. Rambert-Hairston pleaded guilty to money laundering conspiracy on April 16, 2019, and is currently awaiting sentencing.

Christine Yvette Knight., 50, of Clermont, Florida, allegedly prepared fraudulent treatment notes and billing spreadsheets for companies owned and operated by Tony Taylor and Jerry Taylor. She is charged with health care fraud conspiracy and is currently awaiting trial.

Tony Taylor was released on bond following the plea hearing. The health care fraud conspiracy charge carries a maximum prison sentence of 10 years and a $250,000 fine.  The tax evasion charge carries a maximum of five years in prison and a $250,000 fine or twice the actual gain, or both.  A sentencing date for Tony Taylor has not been set yet.

The investigation was handled by MID.  Assistant U.S. Attorney Dallas Kaplan and Special Assistant U.S. Attorney Timothy Rodgers of the U.S. Attorney’s Office in Charlotte.

The investigation and charges are the work of the Western District’s joint Health Care Fraud Task Force.  The Task Force is multi-agency team of experienced federal and state investigators, working in conjunction with criminal and civil Assistant United States Attorneys, dedicated to identifying and prosecuting those who defraud the health care system, and reducing the potential for health care fraud in the future. The Task Force focuses on the coordination of cases, information sharing, identification of trends in health care fraud throughout the region, staffing  of  all  whistle  blower  complaints,  and  the  creation  of  investigative  teams  so  that individual agencies may focus their unique areas of expertise on investigations.  The Task Force builds upon existing partnerships between the agencies and its work reflects a heightened effort to reduce fraud and recover taxpayer dollars.

To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320

Financial Fraud
Health Care Fraud
USAO - North Carolina, Western

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