A Charlotte behavioral health services provider was sentenced to 135 months in prison for Medicaid fraud, COVID-19 fraud, and money laundering. Ashley Nicole Cross, 42, of Charlotte, was also ordered to serve three years of supervised release and to pay $481,436.08 in restitution. According to filed court documents, evidence presented at trial, and witness testimony, Cross owned and operated Odyssey Health Group (OHG), a Charlotte-based company, which was enrolled with the South Carolina Medicaid Program (SC Medicaid) to provide outpatient behavioral health services to eligible Medicaid beneficiaries. Under SC Medicaid rules, beneficiaries are allowed to use providers within 25-miles of the South Carolina border, including Charlotte.
From 2016 to 2021, Cross’s company submitted fraudulent reimbursement claims to SC 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 (PII) of qualified SC Medicaid beneficiaries to file reimbursement claims totaling more than $1.2 million. In some instances, Cross billed SC Medicaid more than 11 hours and up to 19 hours for one-on-one counseling services in a 24-hour period. To further the scheme and to give the appearance that OHG’s fraudulent claims were legitimate, Cross instructed OHG employees to create fake clinical service notes after she filed fraudulent claims in the names of Medicaid beneficiaries.
