Vice President of Raleigh Healthcare Company Pleads Guilty to Making and Using Fake Physician Orders in Medicare Audit | USAO-EDNC | Department of Justice

2022-09-23 20:18:42 By : Mr. Rui Xiao

RALEIGH, N.C. – Kala Sloan, 28, pleaded guilty today to falsifying physician orders on behalf of a company that billed Medicare for millions of dollars. According to the criminal information and evidence summarized in Court, between 2014 and 2021, Carolina Rehab Products, Inc. (CRP) and Blue File DMC, LLC (Blue File) billed Medicare $50 million for durable medical equipment, such as back, shoulder, knee and wrist braces. The evidence showed that, in many instances, CRP and Blue File billed Medicare without supporting physician orders and without shipping the products.  Tanya Parrish Grant, 51, of Raleigh, Sloan’s co-conspirator, was the CEO and Controller of the companies. Grant pled guilty to Healthcare Fraud in July of 2022 for her role as the orchestrator of the scheme. 

Sloan was the Vice President of Operations for the companies, and knowingly submitted forged documents to prevent Medicare auditors from discovering prior false billings and recouping money.  In October 2020, Cigna, a Medicare Advantage insurer, conducted an audit of claims submitted by CRP for reimbursement.  According to the evidence presented in court, CRP did not have doctor’s orders or medical records sufficient to justify the billing to Cigna.  At the direction of Grant, Sloan prepared blank prescription templates to mimic the orders that should have been in the patient files.  Grant used the templates to forge and backdate the prescriptions to deceive auditors.  Sloan the provided these documents to Cigna as though they were genuine and in existence prior to the audits.

Sloan pleaded guilty to Making/Using False Healthcare Writings and Documents and Aiding and Abetting.  She faces a maximum of up to five years in prison.

Michael Easley, U.S. Attorney for the Eastern District of North Carolina made the announcement after U.S. District Judge Terrence W. Boyle accepted the plea. The United States Department of Health and Human Services Office of the Inspector General, and the Federal Bureau of Investigation,  investigated the case.  Assistant U.S. Attorneys William M. Gilmore and Karen Haughton are prosecuting the case.

Related court documents and information can be found on the website of the U.S. District Court for the Eastern District of North Carolina or on PACER by searching for Case No. 5:22-cr-00191-BO.

If you have knowledge of fraud, waste, abuse, or allegations of mismanagement involving disaster relief operations, contact the National Center for Disaster Fraud toll free at: (866) 720-5721 or e-mail at: disaster@leo.gov  

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