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Attorney General Stein Announces Sentencing in $6.1 Million Medicaid Fraud Case

For Immediate Release:
Wednesday, July 22, 2020

Laura Brewer (919) 716-6484

(RALEIGH) Attorney General Josh Stein announced that Tony Garrett Taylor was sentenced to 96 months in prison followed by two years of supervised release by the United States District Court for the Western District of North Carolina for stealing more than $6.1 million from Medicaid and committing tax evasion. Taylor, a former resident of Harrisburg, was also ordered to pay $6,121,655 to North Carolina Medicaid and $1,124,603 to the U.S. Internal Revenue Service as restitution.

“Medicaid resources are for North Carolinians’ health care,” said Attorney General Josh Stein. “When health care providers defraud the Medicaid program, they’re wasting taxpayer money. My office won’t allow it.”

Taylor pleaded guilty in this case in November 2019. Taylor and his brother, Jerry Lewis Taylor, owned and/or operated several outpatient behavioral health services companies for at-risk youth in North Carolina and other states. In North Carolina, the brothers’ companies included Taylor Behavioral Health Center LLC and Options Driven LLC in Monroe, Design for Change LLC in Raleigh, and SHG Consultants Inc. in Gastonia.

From June 2015 to December 2017, Taylor conspired with his brother and others to submit fraudulent reimbursement claims to the Medicaid program for services that were either never provided or misrepresented the actual services provided in order to increase the reimbursement amount received. Taylor recruited other co-conspirators to participate in the scheme and obtained prospective patient lists with individuals’ Medicaid information to submit the fraudulent claims. As a result of this scheme, Medicaid paid approximately $6.1 million in reimbursements for fraudulent claims.

Taylor also failed to file the appropriate tax return forms after receiving and depositing Medicaid reimbursements to his bank accounts and admitted to taking steps to willfully evade income tax obligations. Taylor spent more than $2.9 million from business accounts and Medicaid fraud proceeds to fund his lifestyle, including air fare, hotels, nightclubs, and shopping expenses.

Jerry Lewis Taylor pleaded guilty to health care fraud conspiracy and tax evasion in June and is currently awaiting sentencing. Three other defendants have also pleaded guilty in connection with the scheme.

The investigation and prosecution of this case was conducted by the North Carolina Department of Justice’s Medicaid Investigations Division, the United States Attorney’s Office for the Western District of North Carolina, the Federal Bureau of Investigation, the Internal Revenue Service’s Criminal Investigation Division, and the U.S. Postal Inspection Service.

More information on this sentencing is available here.

About the Medicaid Investigations Division (MID)

The Attorney General’s MID investigates fraud and abuse by health care 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.

The Medicaid Investigations Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $6,160,252 for Federal fiscal year (FY) 2020. The remaining 25 percent, totaling $2,053,414 for FY 2020, is funded by the State of North Carolina.

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


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