Raleigh woman pleads guilty to Medicaid fraud
Authorities say a Raleigh woman is facing prison time and a fine of nearly $500,000 for defrauding North Carolina's Medicaid program.
The N.C. Attorney General's Office said 54-year-old Gloria J. Sawyer pleaded guilty to five felony counts of obtaining property by false pretenses.
Wake County Superior Court Judge Donald W. Stephens sentenced Sawyer to a minimum of 16 months in prison and ordered her to repay $483,791.47 to the Medicaid program from her work release earnings.
Sawyer entered the plea on Monday. She was one of nine North Carolina health care providers arrested last December as part of a statewide Medicaid fraud sweep.
Investigators said Sawyer concealed her criminal history to obtain a Medicaid Provider number for a company that provides case management services to Medicaid recipients infected with HIV. She went on to bill Medicaid for more than $82,000 in 2009, at least $300,000 in 2010, and more than $92,000 in 2011.
The investigators began looking into Sawyer's billing practices in September 2011 based on a tip from a Medicaid recipient who told the N.C. Division of Medical Assistance that Sawyer's company had billed Medicaid for services that she had not actually received.
The investigation revealed that Sawyer's company didn't provide many of the services for which she was paid, or that the services were provided to patients who did not have HIV. Investigators also discovered a system of fraud in which Sawyer directed employees to create false documents and to back date service notes in an attempt to conceal the fraud.