Woman steals identity of therapist; defrauds Medicaid of million - WBTV 3 News, Weather, Sports, and Traffic for Charlotte, NC

Woman steals identity of therapist; defrauds Medicaid of millions

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SHELBY, NC (WBTV) -

A Shelby woman pleaded guilty in federal court on Friday for her involvement in a health care fraud scheme that defrauded Medicaid of $8 million. She also pleaded guilty to stealing a therapist's identity to commit the fraud and to filing a false tax return.

According to court officials, 37-year-old Victoria Finney Brewton, of Shelby, pleaded guilty to seven counts of health care fraud and health care fraud conspiracy, one count of aggravated identity theft and one count of filing a false tax return.

Brewton admitted that from 2008 to 2012 she and Linda Radeker, also of Shelby, and others submitted in excess of $8 million in false claims to Medicaid.

According to filed court documents and statements made in court, Brewton operated a series of after-school and summer childcare programs in Shelby. Brewton recruited juvenile Medicaid recipients to her childcare programs by promising that the program would be free for Medicaid recipients. After Brewton obtained the children's and families' Medicaid recipient numbers, she used this information to fraudulently bill Medicaid for mental and behavioral health services which were never provided.

According to the criminal information, Brewton was not licensed or qualified to provide mental and behavioral health services and she was not approved by Medicaid.

Instead, Brewton enlisted the assistance of other complicit Medicaid-approved providers, such as Linda Radeker, and in other instances, stole the identity of Medicaid-approved providers.

Court documents indicate that Brewton conspired with Radeker, a licensed professional counselor enrolled with North Carolina Medicaid, to submit claims to Medicaid making it appear that Radeker had provided the services when, in fact, Radeker did not provide any of the services.

Radeker and Brewton then split the Medicaid payments 50/50 for these false claims, Brewton claimed.

Filed documents also indicate that Brewton hired licensed therapist in October 2010 to provide services at Brewton's company, Healing Hearts. Although the therapist provided some mental and behavioral health services while she worked at Healing Hearts, Brewton submitted false and fraudulent claims to Medicaid through her Medicaid provider number far in excess of the services actually provided.

That therapist left Healing Hearts after a year - after learning that Brewton had submitted false claims through her Medicaid provider number. Brewton continued to submit fraudulent claims to Medicaid after the therapist was no longer employed at Healing Hearts.

From April 2011 to May 2012, Brewton submitted in excess of $1.8 million in false claims through the therapist's provider number. According to court documents, Brewton also misused the Medicaid provider numbers of other therapists employed by her companies in order to submit false claims to Medicaid through their numbers.

As part of her plea, Brewton also admitted that she defrauded the United States by filing a false tax return for the year 2009 which intentionally failed to report the income Brewton received from her scheme to defraud Medicaid. She also failed to file tax returns for 2010 and 2011, which further masked the income from her fraud scheme. Brewton agreed to forfeit a 2005 Dodge Magnum which was seized as the proceeds of fraud during the investigation.

Brewton, who was released on bond, faces a mandatory two years in prison consecutive to any other term of imprisonment and a $250,000 fine for the aggravated identity theft charge, a maximum term of 10 years in prison and a $250,000 fine for the health care fraud charges, and a maximum term of three years in prison and a $250,000 fine for the filing of a false tax return charge.

In her plea agreement, Brewton has agreed to pay full restitution to Medicaid for any losses resulting from her criminal scheme. The final restitution amount will be determined by the Court at Brewton's sentencing hearing, which has not been scheduled yet.

Radeker pleaded guilty to charges of health care conspiracy and money laundering on September 13, 2012 and is awaiting sentencing.

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