Major Health Care Fraud Takedown: Five Charged and Eight Convicted in North Carolina

On June 30th, a substantial health care fraud investigation led to significant criminal charges against five individuals and one company in North Carolina. This effort was spearheaded by Acting U.S. Attorney Daniel P. Bubar, highlighting abuses in the Medicaid system by two mental health providers: Our Treatment Center and Partners Against Sexually Transmitted Diseases.

The Conviction of Key Figures

Among the notable figures charged is Kim Jones Kelly, a 68-year-old Licensed Clinical Addiction Specialist from Greenville. Kelly pleaded guilty to Conspiracy to Make and Use Materially False Writings and Documents related to health care matters, facing a potential sentence of up to five years in prison. She is one of eight health practitioners convicted in this sweep.

Other Key Convictions Include:

• Dawn Marie Meacham, 61, Licensed Clinical Mental Health Counselor
• Pius Ondachi, 54, Licensed Clinical Mental Health Counselor
• Tequila Vinson Bogan, 48, Licensed Clinical Mental Health Counselor
• Ifeoma Ezugwu, 56, Licensed Clinical Social Worker Associate
• Queensly Onuzulike, 49, Licensed Clinical Social Worker
• Tamika Rochaelle Autry, 29, Certified Peer Support Specialist

Each of these individuals has been charged for violations related to fraudulent health care documentation practices.

Allegations and Charges

The charges stem from alleged schemes to defraud Medicaid, Medicare, and other insurance carriers. The Department of Justice emphasizes that these cases are part of a broader initiative known as the 2025 National Health Care Fraud Takedown. Key allegations include:

• Kickbacks for patients to attend substance abuse services
• False billing for medical equipment to Medicare

Acting U.S. Attorney Bubar remarked:

“Fraud against our healthcare system is not a victimless crime… Today’s charges demonstrate our offices’ resolve to pursue those who attempt to profit by violating federal law.”

Nationwide Impact

This coordinated enforcement action has resulted in charges against over 300 defendants, with alleged losses said to exceed $14.6 billion. Prosecutors reported seizing over $245 million in assets, including cash and luxury vehicles.

Specific Cases of Interest

• Kimberly Mable Sims, a lab company owner, and others were charged with illegal patient inducements that led to more than $25 million in Medicaid payments.
• Randal Fenton Wood from Florida is implicated in a scheme that billed Medicare for unnecessary durable medical equipment, totaling over $39 million in reimbursements.

Efforts to Combat Health Care Fraud

Government agencies emphasize their commitment to tackling health care fraud, with officials from the FBI and other organizations involved in these crackdowns. James C. Barnacle Jr., Acting Special Agent in Charge of the FBI Charlotte Division, stated:

“These schemes drain taxpayer-funded government programs designed to assist citizens who may not otherwise be able to afford healthcare.”

Continued Vigilance

Local and federal authorities remain dedicated to fighting health care fraud. For instance, Kelly J. Blackmon, Special Agent in Charge with the U.S. Department of Health and Human Services, stated:

“Individuals and entities that participate in federal healthcare programs are expected to obey the laws meant to preserve the integrity of program funds.”

This extensive operation reflects ongoing efforts to uphold the quality of care in the healthcare system while preserving taxpayer resources.

Conclusion

The recent health care fraud takedown in North Carolina serves as a stark reminder of the ongoing battle against fraud in the healthcare sector. As more individuals are brought to justice, the government continues to push for integrity in health care services, ensuring that resources are used ethically.

For ongoing updates on health care fraud enforcement, visit the Department of Justice.