DOJ: Magnolia woman fraudulently bills Medicaid for nonexistent mental health services

• McLeod used a nurse practitioner's identity to submit fraudulent claims without consent.
• She received approximately $453,323 from Medicaid as a result of the fraud.

Tekiyah McLeod, registered agent for nLove Community Services LLC, admitted to submitting fraudulent Medicaid claims for mental health therapy services that were never provided, including claims for herself. She used a nurse practitioner's name and National Provider Identifier without consent to further the scheme.

McLeod received approximately $453,323 from Medicaid due to these fraudulent claims. She faces up to 10 years in federal prison for health care fraud, a mandatory two-year consecutive sentence for aggravated identity theft, and a possible $250,000 maximum fine, with sentencing scheduled for Dec. 16.

• $477,872 Fraudulent Medicaid claims billed
• $453,323 Amount received from Medicaid
• $250,000 Maximum possible fine

• Review claims submitted by nLove Community Services LLC for mental health therapy services.
• Verify use of nurse practitioner National Provider Identifiers in Medicaid claims for unauthorized activity.
• Monitor entities and individuals flagged by the National Fraud Enforcement Division for Medicaid fraud typologies.

This case highlights the risk of fraudulent billing and identity theft within Medicaid programs, emphasizing the need for robust controls and verification of provider identities. Compliance officers must ensure that claims are legitimate and that provider credentials are not misused. The DOJ’s focus on fraud enforcement and the creation of the National Fraud Enforcement Division signal increased scrutiny and potential penalties for violations, making it critical for compliance teams to proactively detect and prevent similar schemes.