Medicare Fraud Result in Charges Against Raleigh and Greensboro Men | USAO-EDNC

RALEIGH, N.C. – Today, a federal grand jury returned an Indictment charging Furman Alexander Ford, 51, of Raleigh with conspiring to defraud the Medicare Program by submitting false claims for services that were never provided in order to obtain money what was not owed.  On August 26, 2020, Jimmy Guess, 62, of Greensboro pled guilty to the conspiracy to defraud Medicare.

According to the indictment, Furman Ford hired Jimmy Guess to be a consultant for his company, Integrated Alliance for Managed Healthcare, PLLC (“IAM Healthcare”) and to provide mental health services to the company’s patients primarily through a telehealth model.  Guess was a licensed clinical social worker who provided mental health services. 

According to the indictment, beginning around December 2018, and continuing until around February 2020, in the Eastern District of North Carolina and elsewhere Ford and Guess conspired with others in a scheme to defraud Medicare by submitting false claims to Medicare for mental health services that were never provided to Medicare beneficiaries.  Specifically, Ford, Guess and others conspired to submit claims to Medicare, totaling approximately $242,964.15, for mental health services allegedly provided to approximately 73 beneficiaries between in or around October 2018 and in or around February 2020, when the conspirators well knew and believed the beneficiaries never received the billed services.

The indictment further alleges that in another part of the conspiracy that Ford and others, gathered the Medicare information of unsuspecting beneficiaries by marketing telehealth services and electronic records services to various entities, which often resulted in the exchange of Medicare beneficiary information.  Moreover, Ford, through the IAM Healthcare Foundation, offered food in exchange for Medicare beneficiary information.     Medicare paid IAM Healthcare approximately $163,271.74 because of the conspirators’ fraudulent claim submissions.

Robert J. Higdon, Jr., U.S. Attorney for the Eastern District of North Carolina made the announcement. The Federal Bureau of Investigation, and the United States Department of Health and Human Services Office of the Inspector General, are investigating the case.

Assistant United States Attorney Ethan A. Ontjes and Special Assistant United States Attorney Tamika G. Moses are prosecuting these cases. 

Should you feel that you or a family member are a victim of this case, please contact the United States Department of Health and Human Services Office of the Inspector General at (305) 968-6960.

A copy of this press release is located on our website.  This case is part of the largest health care fraud and opioid enforcement action in Department of Justice history.  See here

An indictment is merely an accusation. The defendants are presumed innocent until proven guilty.

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