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Attorney General Josh Stein Announces Medicaid Fraudster Sentencing

RALEIGH, NC (February 15, 2019) — Attorney General Josh Stein today announced that Tamara McCaffity of Durham was sentenced to 46 months in prison and three years of supervised release following a conviction for Conspiracy to Commit Health Care Fraud in the United States District Court for the Eastern District of North Carolina. She was also ordered to pay restitution in the amount of $523,783 and forfeit three houses. Two other individuals, Christopher Brown and Darryl Sanford, have already pleaded guilty and were sentenced as part of this conspiracy.  

“When people defraud the Medicaid program, they’re cheating taxpayers and taking away resources from people who need healthcare,” said Attorney General Josh Stein. “My office will continue to hold people responsible for these fraudulent practices.”

McCaffity operated three mental health providers – Dreamworks II, Prominence Consulting & Therapeutic Services, and First Choice Health Services. Dreamworks II was an actual business located in Durham, Prominence was a shell corporation registered in Raleigh, and First Choice Health Services was in Greensboro. As part of the conspiracy, McCaffity used purchased stolen Medicaid beneficiary information and other healthcare providers’ National Provider Identifier numbers to fraudulently bill for services that were never rendered through her three provider companies. From January 2013 until May 2016, McCaffity defrauded the North Carolina Medicaid program out of more than $900,000 in claims.

The investigation of this case was conducted by the FBI and the Medicaid Investigations Division of the North Carolina Attorney General’s Office.

About the Medicaid Investigations Division (MID)

The Attorney General’s MID investigates fraud and abuse by healthcare companies and providers, as well as patient abuse and neglect in facilities that are funded by Medicaid. Medicaid is a joint federal-state program that helps provide medical care for people with limited income. To date, the MID has recovered more than $500 million in restitution and penalties for North Carolina.

To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.