Charlotte woman convicted of Medicaid fraud - | WBTV Charlotte

Charlotte woman convicted of Medicaid fraud


A federal jury convicted a Charlotte woman of Medicaid fraud Friday.

37-year-old Charlotte Elizabeth Garnes of Charlotte was convicted of defrauding Medicaid of at least $650,000, obstructing an official proceeding, and making false statements in connection with a health care matter. She was convicted of all twelve counts charged in the indictment. The conviction followed a weeklong trial.

Garnes, a Licensed Professional Counselor, was approved by Medicaid to provide mental and behavioral health services to qualified individuals.

Between March 2009 and April 2011, Medicaid paid Garnes and her company Charlotte's Insight, Inc. approximately $740,349. Approximately 90% of that – about $666,062 – was paid based on false claims. 

During the trial, evidence showed Garnes conspired with others to defraud the system. Two others have already been sentenced.

Numerous Medicaid recipients and their parents testified they never received the therapy services Garnes claimed to have provided.

Many of the dates Garnes submitted claims for were dates when she was not in the state, or even in the country. In one such instance, she billed Medicaid for services she claimed to have provided in Charlotte while she was working a government contract in Germany.

Garnes also routinely billed for more than 24 hours of therapy services in a single day, including at least one instance in which she claimed 69 hours of individual therapy services in a single 24-hour day.

Prosecutors said after Garnes was paid by Medicaid for those false claims, she kept 30% of the proceeds, and distributed the rest to her co-conspirators.

Garnes has not yet been sentenced and is free on bond. She faces a statutory maximum sentence of 10 years in prison and a $250,000 fine for count one. Count two carries a statutory maximum of 20 years in prison, and $250,000 fine. Counts three through twelve carry a statutory maximum sentence of 5 years in prison and a $250,000 fine.

If you suspect Medicare or Medicaid fraud, call 1-800-447-8477, or email HHSTips@OIG.HHS.Gov. To report Medicaid fraud in North Carolina, you can also call the North Carolina Medicaid Investigations Division at 919-881-2320.

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