Ashley Nicole Cross, a behavioral health services provider in Charlotte, has been indicted on federal charges related to defrauding the South Carolina Medicaid Program (SC Medicaid) and falsely obtaining COVID-19 relief funds. The 16-count federal indictment includes charges of healthcare fraud, making false writings concerning healthcare matters, making false statements concerning healthcare matters, promotion money laundering, wire fraud, wire fraud conspiracy, and wire fraud affecting a financial institution.
Cross owned and operated Odyssey Health Group (OHG), a Charlotte-based company enrolled with SC Medicaid, which provided outpatient behavioral health services to eligible Medicaid beneficiaries in South Carolina. The indictment alleges that from 2016 to 2021, Cross conducted a healthcare fraud scheme by submitting fraudulent reimbursement claims to SC Medicaid and its managed care organizations for rehabilitative behavioral health services that were never provided. She allegedly paid for the personal identifying information (PII) of eligible SC Medicaid beneficiaries and used it to file fraudulent reimbursement claims totaling at least $400,000. Cross also allegedly instructed OHG employees to create fictitious patient files and clinical service notes to make the fraudulent claims appear legitimate.
In September 2019, Cross was reportedly informed of an audit into OHG’s claims, and she allegedly submitted fictitious patient medical records and made false statements to the auditor to cover up the fraud. The indictment also alleges that Cross engaged in money laundering and used some of the fraudulent proceeds to promote the scheme by paying for Medicaid beneficiary names and PII.
In a separate scheme from April 3, 2020, to May 14, 2022, Cross is accused of obtaining fraudulent Paycheck Protection Program (PPP) loans on behalf of OHG and Gucci International Inc., an event planning business owned by a co-conspirator. To obtain the PPP loans, Cross allegedly submitted loan applications and supporting documents containing false statements about payroll expenses, the number of employees, and other misrepresentations. As a result, Cross and her co-conspirator obtained over $120,000 in COVID-19 relief funds for OHG and Gucci.
Cross will appear in federal court for her initial appearance, and the charges against her are allegations. If convicted, Cross could face significant prison sentences, including up to 10 years for healthcare fraud, five years for making false writings and false statements concerning healthcare matters, 20 years for promotion money laundering and wire fraud, and 30 years for wire fraud conspiracy affecting a financial institution.
The FBI investigated the case with the assistance of the South Carolina Attorney General’s Office, Medicaid Fraud Investigations, and Assistant U.S. Attorney Michael E. Savage of the U.S. Attorney’s Office in Charlotte is prosecuting the case.
By FCCT Editorial Team