March 5, 2021

A North Carolina corporation was sentenced today to 5 years’ probation and ordered to pay a $2,000,000 fine in addition to paying $10,069,361.35 in restitution to the North Carolina Medicaid Program on a charge of Healthcare Fraud, in violation of Title 18, United States Code, Section 1347.  The company and its owner have also agreed to pay millions to the United States and State of North Carolina to resolve related civil claims under the federal and state False Claims Acts.  In that same civil action, the Governments have obtained a multi-million-dollar judgment against one of the company’s employees.

According to court documents, A Perfect Fit for You, Inc., was a durable medical equipment provider located in Morehead City, North Carolina, and owned by Margaret A. Gibson.   Durable medical equipment includes items such as powered wheelchairs, orthotic braces, diabetic shoes, powered air flotation beds, osteogenesis stimulators, pneumatic compressors, etc.  Between March 2015 and November 2016, one or more employees of A Perfect Fit for You submitted fraudulent billings claims to Medicaid for providing durable medical equipment to Medicaid recipients.  These fraudulent claims contained the personal identifying information of Medicaid recipients who had never ordered nor received any durable medical equipment from A Perfect Fit for You.   In fact, some of the patients had been deceased years before the false claims were even submitted.  This scheme resulted in an estimated loss to Medicaid of approximately $10,069,361.35.  Read the full press release.

Source: Department of Justice

If you suspect Medicare fraud contact Ohio SMP 1-800-488-6070 option 7, use the “Report Fraud” button on this App, or click here.