CHARLOTTE, NC – A federal jury found a Charlotte mental health care provider guilty on Friday, after a nine-day trial, of fraud against the South Carolina Medicaid Program (SC Medicaid), getting COVID-19 relief funds without permission, and laundering money.
Based on the U.S. Attorney’s Office for the Western District of North Carolina, Ashley Nicole Cross, 41, from Charlotte, was found guilty of healthcare fraud, making false statements and writings about a healthcare issue, promotional money laundering, wire fraud, and conspiracy.
The trial evidence, which included 25 witnesses and more than 600 documents, showed that Cross owned and ran the Charlotte-based Odyssey Health Group (OHG), which was contracted by SC Medicaid to offer outpatient mental health services to Medicaid recipients who were qualified. SC Medicaid rules say that recipients can see any provider within 25 miles of the border with South Carolina. This includes Charlotte. Cross’s company lied on reimbursement claims to SC Medicaid and its contracted managed care organizations from 2016 to 2021 for mental health rehabilitation services that were never given.
Cross used the personally identifiable information (PII) of eligible SC Medicaid recipients to make $1.3 million in reimbursement claims as part of the scheme. Cross bought personally identifiable information (PII) about Medicaid recipients that she used to file some claims. Cross told OHG employees to make fake clinical service notes after she made false Medicaid claims in the names of Medicaid recipients. This was done to further the scheme and make it look like OHG’s false claims were real.
In September 2019, Cross was told that OHG’s Medicaid claims were being audited, according to proof presented in court. Cross lied to inspectors and gave them fake medical records for patients in order to hide the fraud. Cross was also found to have laundered money and used some of the money he stole to spread the scheme by buying Medicaid beneficiary names and personal information.
Along with the Medicaid fraud scheme, evidence showed that from April 3, 2020, to May 14, 2022, Cross ran a scheme to get fake Paycheck Protection Program (PPP) loans for OHG and Gucci International Inc. (Gucci), a business that Cross’s boyfriend and co-conspirator said planned events.
Cross-filled out loan applications and sent in supporting documents that lied about OHG and Gucci’s payroll costs, the number of workers, and other things in order to get the PPP loans. Cross got more than $287,000 in COVID-19 aid for her businesses and Gucci. Cross’s man was being charged with a federal crime at the time Gucci applied for a loan.
After the jury gave their decision, Cross was taken back into custody.
The judge in the federal district court will decide Cross’s sentence by looking at the U.S. Sentencing Guidelines and other legal issues. This person has not been given a sentence date.
