Date: 06-17-2024

Case Style:

United States of America v. Felicia Moore Jones

Case Number: 5:23-CR-00377-BO

Judge: Terrence W. Boyle

Court: The United States District Court for the Eastern District of North Carolina

Plaintiff's Attorney: The United States Attorney’s Office for Raleigh

Defendant's Attorney:

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Description:

Raleigh, N.C. criminal defense lawyer represented the Defendant charged with Conspiring to Defraud Medicaid
New Hanover County Social Worker Sentenced to Prison for Conspiring to Defraud Medicaid

Felicia Moore Jones, 52, was sentenced to 14 months in federal prison followed by three years of supervised release for conspiring to defraud North Carolina Medicaid of more than $400,000. Jones was also ordered to pay $400,000 in restitution.

“This defendant used her government position to steal from a government program intended to help the needy,” said U.S. Attorney Michael Easley. “Now, she will be forced to repay what she took and spend the next 14 months behind bars.”

Jones was a social worker in New Hanover County who conspired with a licensed mental health counselor, Lakia Washington, to defraud North Carolina Medicaid (“Medicaid”). Jones used her government employment to obtain personally identifying information (PII) of New Hanover County residents enrolled in Medicaid, including their Medicaid ID numbers. In exchange for an agreed-upon fee per beneficiary, Jones then provided the PII to Washington, knowing it would be used to generate fraudulent claims for services never rendered. Investigators have attributed over $400,000 of Washington’s fraudulent Medicaid billing to the beneficiary PII Jones provided to Washington. Washington pled guilty late last year and is awaiting sentencing.

“HHS-OIG, along with our law enforcement partners, is committed to holding individuals responsible for failing to safeguard confidential patient information,” said Special Agent in Charge Tamala E. Miles of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “Ms. Jones was a social worker who violated the trust of her duties by accessing the personal and health data of Medicaid recipients and using the confidential information for personal gain.”

The Center for Medicaid Services, within the federal Department of Health and Human Services, is responsible for overseeing the Medicaid program in North Carolina, which has been administered by the North Carolina Department of Health and Human Services since 1978. Medicaid providers are assigned a National Provider Identifier, which they use to submit claims for reimbursement for services rendered to Medicaid beneficiaries.

Michael Easley, U.S. Attorney for the Eastern District of North Carolina, made the announcement after U.S. District Judge Terrence W. Boyle announced the sentence. The U.S. Department of Health and Human Services, Office of the Inspector General, led the investigation with the assistance North Carolina Medicaid Investigations Division, and Assistant U.S. Attorney David G. Beraka prosecuted the case.

Outcome:

Defendant was found guilty and sentenced to 14 months in federal prison followed by three years of supervised release

Plaintiff's Experts:

Defendant's Experts:

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