The owner and operator of a Buckhead-based healthcare company has been sentenced to five years and three months in federal prison after pleading guilty to a $1.2 million Medicaid fraud scheme, according to the U.S. Attorney for the Northern District of Georgia.
Diandra Bankhead, 43, used her company, Elite Homecare, to submit thousands of fraudulent claims for Medicaid services that were never provided to medically fragile children under the Georgia Pediatric Program, U.S. Attorney BJay Pak wrote in a news release Wednesday.
“It is outrageous that Bankhead profited off children who suffered from significant physical and cognitive disabilities,” Pak said. “For years her scheme exploited Medicaid-eligible children and their families by billing for services never performed and for children never seen, diverting critical resources from those who needed them most.”
GAPP is an in-home nursing program that offers services, like feeding and bathing, to children who suffer from physical and cognitive disabilities, such as those who have cerebral palsy, blindness or paralysis, authorities said. Between September 2015 and April 2018, Bankhead submitted more than 5,400 claims as a GAPP provider, the release said. Most of the claims were found to be fraudulent by investigators.
According to Pak, Bankhead defrauded Medicaid in various ways, which included preparing false documentation for services that were never provided and submitting fake credentialing information to the state’s Department of Community Health to become a certified GAPP provider.
During one instance, Bankhead submitted fraudulent claims stating her business provided services to an infant girl after she died and three children who suffered from cerebral palsy or Down Syndrome, Pak said.
Investigators also discovered that Bankhead failed to properly disclose her finances. Instead, authorities found that she “entered into a kickback arrangement with another Atlanta-based home health provider under which she ‘sold’ twenty of Elite’s former clients in exchange for receiving a percentage of the Medicaid billings tied to those clients going forward,” Pak said.
Bankhead pleaded guilty to one count of health care fraud on Aug. 28, 2019. In addition to serving time in jail, Bankhead will have to undergo three years of supervised release and pay $999,999 in restitution.
The case was investigated by the Department of Health and Human Services, Georgia Medicaid Fraud Control Unit, and the FBI.
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