Federal Judge Sentences Charlotte Licensed Clinical Social Worker To 11+ Years In Prison For Medicaid Fraud, COVID-19 Fraud, And Money Laundering

Press Release

CHARLOTTE, N.C. - A Charlotte behavioral health services provider was sentenced yesterday to 135 months in prison for Medicaid fraud, COVID-19 fraud, and money laundering, announced Dena J. King, U.S. Attorney for the Western District of North Carolina. Ashley Nicole Cross, 42, of Charlotte, was also ordered to serve three years of supervised release and to pay $481,436.08 in restitution. On May 17, 2024, following a nine-day trial, a federal jury found Cross guilty of healthcare fraud, making false statements and writings relating to a healthcare matter, promotional money laundering, wire fraud, and conspiracy.

Robert M. DeWitt, Special Agent in Charge of the Federal Bureau of Investigation (FBI), Charlotte Division, and Stephanie G. Opet, Director of the South Carolina Medicaid Fraud Control Unit, join U.S. Attorney King in making today's announcement.

According to filed court documents, evidence presented at trial, and witness testimony, Cross owned and operated Odyssey Health Group (OHG), a Charlotte-based company, which was enrolled with the South Carolina Medicaid Program (SC Medicaid) to provide outpatient behavioral health services to eligible Medicaid beneficiaries. Under SC Medicaid rules, beneficiaries are allowed to use providers within 25-miles of the South Carolina border, including Charlotte. From 2016 to 2021, Cross's company submitted fraudulent reimbursement claims to SC Medicaid and its contracted managed care organizations for rehabilitative behavioral health services that were never provided. To carry out the scheme, Cross used the personal identifying information (PII) of qualified SC Medicaid beneficiaries to file reimbursement claims totaling more than $1.2 million. In some instances, Cross billed SC Medicaid more than 11 hours and up to 19 hours for one-on-one counseling services in a 24-hour period. To further the scheme and to give the appearance that OHG's fraudulent claims were legitimate, Cross instructed OHG employees to create fake clinical service notes after she filed fraudulent claims in the names of Medicaid beneficiaries.

Court documents show that, in the course of the investigation, FBI agents identified and interviewed 21 Medicaid beneficiaries whose names, Medicaid numbers, and PII were used to file claims on behalf of Cross and OHG. Each of those beneficiaries stated that neither they nor their children received mental health services from Cross. Many beneficiaries stated that the information written about them in OHG's assessments and clinical notes were not true, while others said that their signatures had been forged.

Cross engaged in money laundering and used some of the fraudulent proceeds to promote the scheme by paying for Medicaid beneficiary names and PII.

According to court documents in September 2019, Cross was informed of audits of OHG's Medicaid claims. To cover up the fraud, Cross submitted fictitious patient medical records and made false statements to auditors. Court records show that, the fraud at OHG was so pervasive, it was impossible for investigators to distinguish the fraudulent claims from legitimate ones.

In addition to the Medicaid fraud scheme, from April 3, 2020, to May 14, 2022, Cross executed a scheme to obtain fraudulent Paycheck Protection Program (PPP) loans on behalf of her companies, including OHG, and Gucci International Inc. (Gucci), a purported event planning business owned by Cross's boyfriend and co-conspirator. To obtain the PPP loans, Cross submitted loan applications and supporting documents that contained false statements regarding Cross's companies and Gucci's payroll expenses, number of employees, and other misrepresentations. Cross obtained more than $287,000 in COVID-19 relief funds for her companies and Gucci. At the time of Gucci's loan application, Cross's boyfriend was under indictment for a federal offense.

During the trial, the Court heard testimony that Cross contacted prospective witnesses in violation of the conditions of her bond. One witness identified a recording of a call in which Cross suggested that the witness falsely testify that Cross had provided mental health services to the witness's children. The court noted Cross's attempt to obstruct justice when announcing sentence.

Cross remains in federal custody. She will be transferred to the custody of the Federal Bureau of Prisons upon designation of a federal facility.

The FBI investigated the case with substantial assistance from the South Carolina Attorney General's Office, Medicaid Fraud Control Unit, and the Small Business Administration's Office of Inspector General.

Assistant U.S. Attorney Michael E. Savage and Special Assistant U.S. Attorney Kristina Fleisch of the U.S. Attorney's Office in Charlotte prosecuted the case.

Updated November 22, 2024