North Carolina healthcare company executive pleads guilty to falsifying physician documents, aiding and abetting
Published 9:54 am Sunday, September 25, 2022
Kala Sloan, 28, pleaded guilty on Wednesday, September 21, 2022 to falsifying physician orders on behalf of a company that billed Medicare for millions of dollars, according to a press release from the U.S. Department of Justice, Eastern District of North Carolina.
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,” stated the release.
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, according to the release.
Tanya Parrish Grant, 51, of Raleigh, Sloan’s co-conspirator, was the CEO and controller of the companies. Grant pleaded guilty to healthcare fraud in July of 2022 for her role as the orchestrator of the scheme.
“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,” stated the release. “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 and 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.
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