Columbia, South Carolina – South Carolina Attorney General Alan Wilson has announced a large number of indictments related to a Medicaid scam that took more than $21 million from taxpayers in multiple states. This is a big step in the fight against healthcare fraud.
The revelation was made at a joint press conference in Charlotte, North Carolina, where Wilson was joined by top federal and state authorities as part of a larger effort across the country to stop healthcare fraud.
The investigation, which was called “Operation Border War,” looked into fake behavioral health services that people and businesses in North Carolina and other states charged to South Carolina Medicaid. Nine individuals are now facing significant federal charges, including conspiracy to conduct healthcare fraud, money laundering, and unlawful handling Medicaid beneficiary data.
“Medicaid fraud is theft, plain and simple. It robs taxpayers and puts vulnerable people, including children, at risk by draining critical resources from our healthcare system. My office is aggressively pursuing those who exploit the system, and we won’t stop until every dollar stolen is accounted for and every fraudster is brought to justice,” said South Carolina Attorney General Wilson.
Donald Calvin Saunders, 62, from Charlotte, is one of the people who has been charged. Prosecutors claim he was a key figure in setting up the plan. Saunders and others are said to have acquired and sold the personal information of Medicaid beneficiaries, frequently without their knowledge, and filed thousands of fake claims for services that were never provided. In a lot of cases, licensed provider credentials were used in the wrong way or obtained through deception.
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The investigation discovered a network of fake businesses and billing operations that had been going on since 2017 and would continue until 2024. According to prosecutors, the people who worked with the defendants utilized stolen or fake personal information to file fake claims for reimbursement. In some cases, officials even made up fake Medicaid patients to catch people who were part of the fraud.
The indictments say that people made false claims for behavioral health services near the South Carolina border. Medicaid rules allow these services to be delivered in North Carolina if they are done by approved providers. But a lot of the providers named in the claims weren’t really participating, and the services were never given.
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The indictments also say that there was a complicated system of kickbacks and money laundering going on. Co-conspirators are said to have made unlawful payments look like normal business expenses, like payroll and consultation fees. The goal of these actions was to obscure where the money came from and keep the scam going.
The defendants include individuals from South Carolina, North Carolina, Georgia, and New York. One of them, David Corey Hill of Concord, North Carolina, has agreed to plead guilty and is expected to appear in court soon.
If convicted, those implicated face significant prison time—up to 20 years for money laundering and 10 years for individual fraud convictions. Sentences will be determined by federal judges under sentencing guidelines.
The indictments are part of a bigger effort by the U.S. Department of Justice to stop healthcare fraud all around the country. As part of this effort, more than 300 people around the country have been charged with schemes that cost more than $14 billion.
