Woman Sentenced to Prison for $500K Health Care Fraud Scheme

RICHMOND, Va. – A North Carolina woman was sentenced today to four years in prison for committing a $506,000 fraud on the Virginia Medicaid program

“Medicaid is a system of trust, and Jackson deliberately exploited a loophole in the Virginia Medicaid billing regulations and brazenly bilked taxpayers of over $500,000. When someone commits healthcare fraud, it drives up the cost of care for everyone and creates an unfair playing field. I want to thank our team of investigators, prosecutors, and the Virginia Attorney General’s Medicaid Fraud Control Unit for their terrific work on this case.”

According to court documents, Paulette Jackson, 66, Williamston, was the owner and operator of United Medical Home Oxygen & Medical Supply, a Medicaid-enrolled durable medical equipment provider located in Franklin. When she sought reimbursement from Virginia Medicaid for a certain type of liquid oxygen container refills, Medicaid would reimburse Jackson for her actual oxygen cost plus 30 percent. Jackson inflated the amounts she reported to Medicaid were her actual costs of oxygen. From in 2010 through April 2016, Jackson reported to Medicaid that her costs 45 to 78 times her actual cost of oxygen. From April 2016 through August 2017, Jackson inflated her costs at a rate of 22 times her actual cost of oxygen. By falsely reporting her actual oxygen costs, Jackson, through United Medical, improperly billed Medicaid $506,058.66.

G. Zachary Terwilliger, U.S. Attorney for the Eastern District of Virginia; Brian A. Benczkowski, Assistant Attorney General of the Justice Department’s Criminal Division; Mark R. Herring, Attorney General of Virginia; and Maureen R. Dixon, Special Agent in Charge of the Office of Inspector General for the U.S. Department of Health and Human Services (HHS), made the announcement after sentencing by U.S. District Judge John A. Gibney, Jr. Assistant U.S. Attorney Jessica D. Aber and Trial Attorney John Scanlon of the Criminal Division’s Fraud Section prosecuted the case.

A copy of this press release is located on the website of the U.S. Attorney’s Office for the Eastern District of Virginia. Related court documents and information are located on the website of the District Court for the Eastern District of Virginia or on PACER by searching for Case No. 3:19-cr-20.