On May 17, 2024, Ashley Nicole Cross was convicted of COVID-19 fraud. From April 3, 2020, to May 14, 2022, Cross executed a scheme to obtain fraudulent Paycheck Protection Program loans on behalf of her company Odyssey Health Group (OHG). Cross submitted the COVID-19 loan applications utilizing the same strategy as all our other COVID-19 loan fraudsters. Submitting supporting documents that contained false statements regarding OHG’s payroll expenses, number of employees and other misrepresentations. The difference with Cross’s applications was that her company was actively defrauding the U.S. Medicaid department. Cross was that her fraudulently filing for a Small Business Administration backed loan designed to keep businesses during COVID-19 afloat. For her, a business that was also fraudulently filing Medicaid claims. The irony.
From 2016 to 2021, Cross’s company submitted fraudulent reimbursement claims to South Carolina Medicaid and its contracted managed care organizations for rehabilitative behavioral health services that were never provided. To carry out the scheme, Cross used the personal identifying information of qualified S.C. Medicaid beneficiaries to file reimbursement claims totaling $1.3 million. For some claims, Cross bought the personal identifying information of Medicaid beneficiaries she used to submit claims. To further the scheme and to give the appearance that the fraudulent claims were legitimate, Cross instructed her employees to create fake clinical service notes after she filed fraudulent claims in the names of Medicaid beneficiaries. Make it look good and you keep your job.
In September 2019, Cross learned of an audit into OHG’s claims. The indictment alleges that Cross submitted fictitious patient medical records and made false statements to the auditor in order to cover up the fraud. Not only did she not stop, she tried to cover up the scheme by submitting fictitious patient medical records to auditors. And it didn’t stop her from fraudulently applying for COVID-19 loans. Fraudsters love help in paying their employees.
Great job by the COVID-19 Fraud Enforcement Task Force.
Today’s Fraud of The Day is based on article “Charlotte business owner convicted of Medicaid, COVID fraud” published by Business NC on May 18, 2024.
A federal jury convicted a Charlotte behavioral health services provider on charges related to Medicaid and COVID-19 relief fraud, as well as money laundering, after a nine-day trial, according to the U.S. Attorney’s Office in Charlotte.
Ashley Nicole Cross, 41, of Charlotte, was taken into custody after the guilty verdict and now awaits sentencing. The jury found Cross guilty of defrauding the South Carolina Medicaid Program, making false statements and writings relating to a healthcare matter, promotional money laundering, wife fraud and conspiracy.
