NC Medicaid biller pleads guilty to health care fraud

Health care fraud graphic by MGN.

RALEIGH, N.C. (WITN) Attorney General Josh Stein says that behavioral health services company owner Pamela Grace Faulkner pleaded guilty to one count of conspiracy to commit health care fraud in the Eastern District of North Carolina.

Faulkner owned Skeen Services Inc., a company that offered behavioral health services to Medicaid recipients, and conspired with another individual, Renee Christine Borunda, to submit fraudulent Medicaid claims. Stein says often, Faulkner provided Borunda with the names of clients for this purpose.

In 2013 and 2014, Borunda submitted fraudulent claims to Medicaid for services that had never been provided for approximately 200 different Medicaid recipients from Beaufort, Greene, Guilford, Lenoir, Mecklenburg, Pitt, and Wilson Counties. Faulkner and Borunda had agreed to split the monies received for these claims, which totaled approximately $213,927 from the Medicaid program.

Borunda, who had submitted false Medicaid claims on behalf of another company in addition to Skeen, previously pleaded guilty to conspiracy to commit health fraud and aggravated identity theft, and was sentenced in November to 37 months in federal prison followed by three years of supervised release.

Officials have not said when Faulkner will be sentenced of what that sentence may be.

The investigation and prosecution of this case was handled by the United States Attorney’s Office for the Eastern District of North Carolina and the Medicaid Investigations Division.