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Attorney General Josh Stein Announces Two Medicaid Behavioral Health Fraud Convictions

Release date: 12/7/2018

(RALEIGH) Attorney General Josh Stein today announced that Lisa Carol Raymond of Greenville, North Carolina, and Robert Paul Maglicic, Jr., of Miami, Florida, pleaded guilty to Conspiracy to Commit Health Care Fraud in the United States District Court for the Eastern District of North Carolina.

“When people cheat Medicaid, they’re cheating taxpayers,” said Attorney General Josh Stein. “My office will continue to hold people responsible when they take part in these fraudulent and wasteful practices.”

As employees of South Carolina-based provider Southern Support Services, Maglicic and Raymond fraudulently billed the South Carolina Medicaid program for more than $595,000 in 2013 and 2014 for fictitious behavioral health services, and for an additional $1.4 million between December 2014 and April 2015. When the South Carolina Medicaid program conducted an audit of Southern Support Services and requested records for more than 160 different patient billings, Maglicic and Raymond used employee names from Carolina Support Services, a North Carolina-based provider, to create fake employee profiles. They then used these employee profiles to create false Medicaid records and made it appear that these fictitious employees were assisting patients in South Carolina to justify the Medicaid billings. In total, they caused losses totaling more than $2 million to the Medicaid program.

Both Southern Support Services and Carolina Support Services were owned by Shepard Lee Spruill, who was sentenced in July 2018 to 96 months in federal prison for fraud committed against the North Carolina Medicaid program. Maglicic and Raymond face up to 10 years in prison as well as fines, supervised release, and mandatory restitution.

The investigation of this case was conducted by the United States Department of Health and Human Services Office of the Inspector General, the Medicaid Investigations Division of the North Carolina Attorney General’s Office, and the Internal Revenue Service Criminal Investigation.

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 $500 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.

Laura Brewer (919) 716-6484


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