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Attorney General Josh Stein Announces Health Care Fraud Conviction

For Immediate Release:
Thursday, October 17, 2018

(RALEIGH) Attorney General Josh Stein today announced that behavioral health services company owner Pamela Grace Faulkner pleaded guilty to one count of conspiracy to commit health care fraud in the Eastern District of North Carolina.

“This individual wasted taxpayer money that should have gone to people who need health care,” said Attorney General Josh Stein. “My office will protect taxpayers and hold health care providers and practices accountable when they commit fraud.”

Faulkner owned Skeen Services Inc., a company that offered behavioral health services to Medicaid recipients, and conspired with another individual, Renee Christine Borunda, to submit fraudulent Medicaid claims. Often, Faulkner provided Borunda with the names of clients for this purpose. In 2013 and 2014, Borunda submitted fraudulent claims to Medicaid for services that had never been provided for approximately 200 different Medicaid recipients from Beaufort, Greene, Guilford, Lenoir, Mecklenburg, Pitt, and Wilson Counties. Faulkner and Borunda had agreed to split the monies received for these claims, which totaled approximately $213,927 from the Medicaid program.

Borunda, who had submitted false Medicaid claims on behalf of another company in addition to Skeen, previously pleaded guilty to conspiracy to commit health fraud and aggravated identity theft, and was sentenced in November to 37 months in federal prison followed by three years of supervised release.

The investigation of this case was conducted by the North Carolina State Bureau of Investigation, the North Carolina Department of Justice’s Medicaid Investigations Division (MID), and the Internal Revenue Service – Criminal Investigation, with assistance from the Office of Compliance and Program Integrity of the North Carolina Division of Health Benefits, EastPointe, Sandhills Center, and Trillium Health Resources.

The investigation and prosecution of this case was handled by the United States Attorney’s Office for the Eastern District of North Carolina and MID.

About the Medicaid Investigations Division (MID)

The Attorney General’s MID investigates fraud and abuse by healthcare companies and providers, as well as patient abuse and neglect in facilities that are funded by Medicaid. Medicaid is a joint federal-state program that helps provide medical care for people with limited income. To date, the MID has recovered more than $850 million in restitution and penalties for North Carolina.

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

Contact:
Laura Brewer (919) 716-6484

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