MONROE — Tony Garrett Taylor, a co-owner of Taylor Behavioral Health Center, LLC and Options Driven, LLC in Monroe, has been sentenced to eight years in prison followed by two years of supervised release for the theft of more than $6.1 million from Medicaid and committing tax evasion, according to Andrew Murray, U.S. Attorney for the Western District of North Carolina.
Taylor has been ordered to pay $6,121,655 to North Carolina Medicaid and $1,124,603 to the U.S. IRS as restitution. U.S. District Judge Robert J. Conrad Jr. delivered the sentence on Tuesday (July 21).
Taylor, 40, is a native of Harrisburg, but currently resides in Brooklyn, New York. He and his brother Jerry Lewis Taylor submitted false and fraudulent reimbursement claims for patient services that either did not exist or were mischaracterized to Medicaid, according to the report. The claims were made through their companies in Monroe in addition to Design for Change, LLC in Raleigh and elsewhere; and SHG Consultants in Gastonia. These businesses supplied outpatient behavioral health services to at-risk youth, according to a press release from the Department of Justice.
This occurred from June 2015 to December of 2017. The scheme defrauded Medicaid of more than $9.4 million.
“During the course of the fraudulent scheme, Tony and Jerry Taylor caused hundreds of false and fraudulent claims to be submitted to Medicaid for false and fraudulent services. As a result, more than $9.4 million in fraudulent claims were submitted to Medicaid, resulting in approximately $6.1 million in fraudulent payments from Medicaid,” according to the statement.
Taylor, with assistance from others, was found to have compiled a list of prospective patients that contained information for eligible Medicaid beneficiaries. Using that information, he and co-conspirators filed fraudulent reimbursement claims for services that were never provided. For services that were provided, the conspirators submitted fraudulent claims to Medicaid that misrepresented services in order to obtain a higher reimbursement rate. This is also known as upcoding.
“According to court documents, Tony Taylor also recruited Devon Rambert-Hairston, a licensed nurse practitioner and the director of one of the entities operated by the brothers, to review and sign-off on fictitious patient progress notes. Court records show that Rambert-Hairston never provided any behavioral health or medical services to the Medicaid beneficiaries or rarely interacted with them at all. To the extent that the beneficiaries received any treatment, those services were provided by an individual identified in court documents as J.B., who was not credentialed to provide those types of services,” per the Department of Justice.
Taylor committed tax evasion by failing to file income tax returns for tax years 2015, 2016 and 2017. Too, he diverted fraudulent receipts from Medicaid to nominee entities and individuals.
“Tony Taylor also made personal expenditures using business accounts and Medicaid fraud proceeds, including spending more than $2.9 million for his ‘opulent lifestyle,’ air fare, hotels, nightclubs, and shopping,” according to the statement.
Taylor pleaded guilty to health care fraud conspiracy and tax evasion. He is currently released on bond and upon designation of a federal facility he will report to the federal Bureau of Prisons to begin serving his sentence.
Jerry Taylor’s sentencing has yet to be announced. He plead guilty to health care fraud conspiracy.