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A Gentle Nudge

Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Keyana Lanice Jamill Carter, 29, of Nevada has been found guilty of Medicaid fraud. Carter was sentenced for billing clients for Medicaid services that she did not provide. (That’s one of the oldest Medicaid fraud scams in the book.)

Carter admitted to submitting the falsified claims, which failed to maintain sufficient records to support the claims, to Nevada Medicaid. The fraudulent claims were submitted over the span of two years. Between July 2017 and June 2019, Carter billed Medicaid for services that she never provided for her company, Gentle Touch Behavioral Health LLC. (Truth be told, she needs a gentle nudge in a law-abiding direction.)

To strengthen her fictitious claims, Carter allegedly requested that her employees create false records to document the services that she claimed she provided. (One would think she would have kept her plans quiet since she was breaking the law.) By involving her employees, Carter aimed to substantiate her Medicaid claims and improve the likelihood that she would receive payment. (Chances are that one of her employees blew the whistle on her fraudulent actions.) In addition, Carter forged the signatures of other healthcare providers who reported they did not provide the services claimed.

Carter has been sentenced to 364 days in jail with one year of probation to follow for committing Medicaid fraud. In addition, her licenses have been suspended and she must pay $500,000 in restitution. (Half a million dollars to match the half a brain used to collect it.) Carter may also be excluded from participating in Medicaid and Medicare in the future. (That would provide a not-so-subtle reminder that she broke the law.)

Today’s Fraud of the Day comes from an article, “Las Vegas woman sentenced in Medicaid fraud case” published by 8 News Now on June 3, 2021.

LAS VEGAS (KLAS) — A Las Vegas woman who the Nevada Attorney General’s office says was billing clients for Medicaid services she did not provide was sentenced Thursday.

Keyana Lanice Jamill Carter, 29, was sentenced in a Medicaid fraud case involving the failure to maintain adequate records to substantiate claims submitted to Nevada Medicaid between July 2017 and June 2019.

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