Three more plead guilty to health insurance fraud
by MBJ Staff
Published: September 23,2011
BRANDON — Three more defendants have entered guilty pleas concerning their role in an insurance fraud scheme involving the State and School Employees Health Insurance Plan, announced Attorney General Jim Hood.
Fourteen people were charged in the case where three employees of Blue Cross & Blue Shield of Mississippi were accused of conspiring with 11 state employees. Seven others recently pleaded guilty in the case. Four others have yet to plead or go to trial.
The following are the most recent defendants to plead before Judge John Emfinger in Rankin County Circuit Court:
• Erica Ball, 37, pleaded guilty to two counts of conspiracy, two counts of insurance fraud and two counts of making false representations to defraud the government. Ball was sentenced to eight years in the custody of the Mississippi Department of Corrections (DOC) and ordered to pay restitution to Blue Cross & Blue Shield of Mississippi in the amount of $55,723.20 to be paid jointly with her co-defendants. Ball was further ordered to reimburse the State of Mississippi’s General Fund in the amount of $2,865 for the cost of the investigation; and, ordered to pay $200 to the Mississippi Crime Victim’s Compensation Fund and all court costs. Upon her release from prison, she will serve five years on supervised probations. Ball was employed with the Mississippi Department of Human Services at the time of the crime.
• Kathy Carter, 40, pleaded 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. Carter entered on open plea and was immediately taken into custody to await her sentencing hearing Sept. 27 pending the results of her pre-sentence report. She faces up to 36 years in prison and a maximum fine of $60,000. The amount of restitution to Blue Cross & Blue Shield of Mississippi in all causes she is involved in is $37,062.36. Pursuant to MCA Section 7-5-309, she will also be ordered to reimburse the State of Mississippi’s General fund $1,255 for the cost of the investigation. Carter was employed by the Mississippi Division of Medicaid at the time of the crime.
• Tambrella Johnson, 25, of Jackson pleaded guilty to one count of conspiracy, one count of insurance fraud, one count of mail fraud and one count of making false representations to defraud the government. Johnson entered an open plea and was taken into custody to await her Sept. 27 sentencing hearing pending the results of her pre-sentence report. She is facing a maximum sentence of 18 years in prison and a maximum fine in the amount of $30,000. The amount of restitution owed to Blue Cross & Blue Shield of Mississippi in this case is $36,258.56. She is also likely to be ordered to reimburse the State of Mississippi’s General fund $2,445 for the cost of the investigation. Johnson was employed with Mississippi State Hospital at the time of the crime.
Cases are still pending against Fonda Church, 46, of Jackson; Crystal Barnes, 36, of Jackson; Sonya Mitchell, 35 of Jackson; and, Zaveon Cooper, 36, of Jackson.
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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