Five sentenced for insurance fraud scheme

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Published: September 13,2011

Tags: courts, insurance, insurance fraud

BRANDON — Five people have been sentenced for their role in an insurance fraud scheme involving the State and School Employees Health Insurance Plan, according to Attorney General Jim Hood.

Three employees of Blue Cross & Blue Shield of Mississippi were accused of conspiring with 11 state employees. Six others have yet to plea or go to trial.

The five who appeared before Judge John Emfinger last Friday in Rankin County Circuit Court are:

• Christine Degrate, 34, of Jackson was employed at Jackson State University. She pled guilty to two counts of conspiracy, two counts of insurance fraud, two counts of mail fraud and two counts of making false representations to defraud the government. Degrate was sentenced to serve a term of 10 years in the custody of the Mississippi Department of Corrections and ordered to pay restitution to Blue Cross & Blue Shield of Mississippi in the amount of $27,568.62 to be paid jointly with her co-defendants. She was further ordered to reimburse the State of Mississippi’s General Fund in the amount of $1,795 for the cost of the investigation, ordered to pay $200 to the Mississippi Crime Victim’s Compensation Fund and court costs in the amount of $1,646.00. Upon her release from prison, she will serve five years on supervised probation.

• Shantwana Johnson, 36, was employed by the Mississippi Department of Employment Security. She pled guilty to two counts of conspiracy, two counts of insurance fraud, two counts of mail fraud and two counts of making false representations to defraud the government. Johnson entered an “open” plea, meaning she threw herself on the mercy of the court, and was immediately taken into custody to await her sentencing hearing scheduled for Sept. 27 pending the results of her pre-sentence report. She faces a maximum sentence of 36 years in prison and a maximum fine in the amount of $60,000. The amount of restitution owed to Blue Cross & Blue Shield of Mississippi in all causes involving Johnson is $68,023.12. She will also be ordered to reimburse the State of Mississippi’s General fund $2,095 for the cost of the investigation.

• Veronica Newell, 43, of Jackson, formerly employed at Blue Cross & Blue Shield of Mississippi, pled guilty to four counts of conspiracy, four counts of insurance fraud, four counts of mail fraud and four counts of making false representations to defraud the government. She was sentenced to serve a term of 15 years in the custody of the Mississippi Department of Corrections and ordered to pay restitution to Blue Cross & Blue Shield of Mississippi in the amount of $149,216.80 to be paid jointly with her co-defendants. She was further ordered to reimburse the State of Mississippi’s General Fund in the amount of $4,650 for the cost of the investigation, ordered to pay $400 to the Mississippi Crime Victim’s Compensation Fund and court costs in the amount of $2,692. Upon her release from prison, she will serve five years of supervised probation.

• Tiana Whitsett, 35, of Jackson, formerly employed at Blue Cross & Blue Shield of Mississippi, pled guilty to five counts of conspiracy, five counts of insurance fraud, five counts of mail fraud and five counts of making false representations to defraud the government. The sentencing in this case has been deferred until March 2012 due to the fact that the defendant is expecting a child.

Isis Young, 34 of Jackson, formerly employed by Mississippi Department of Corrections, pled guilty to two counts of conspiracy, two counts of insurance fraud, two counts of mail fraud and two counts of making false representations to defraud the government. Young was sentenced to serve a term of 10 years in the custody of the Mississippi Department of Corrections. She was also ordered to pay restitution to Blue Cross & Blue Shield of Mississippi in the amount of $93,512.80 to be paid jointly with her co-defendants. She was further ordered to reimburse the State of Mississippi’s General Fund in the amount of $981 for the cost of the investigation, ordered to pay $200 to the Mississippi Crime Victim’s Compensation Fund and court costs in the amount of $2,046. Upon her release from prison, she will serve five years on supervised probation.

Blue Cross & Blue Shield of Mississippi, which administers the State and School Employees Health Insurance Plan, had three employees who processed claims of up to $44,000 to at least 11 state employees for reimbursement for medical procedures that never occurred. These state employees cashed the checks and kicked back some of the money to the Blue Cross & Blue Shield of Mississippi employees. The total stolen from the State and School Employees Health Insurance Plan is over $500,000.

The scheme unraveled when a participant returned her check to Blue Cross & Blue Shield of Mississippi, which then turned it over to authorities. Blue Cross & Blue Shield of Mississippi has cooperated with the Attorney General Office’s investigation and made a prompt and full refund to the State. The Department of Audit assisted.

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