One Delayed, Six Sentenced in State Health Plan Scheme

● Kwame Smith, age 30, of Greenville, MS, plead on four counts each of Conspiracy, Insurance Fraud, Mail Fraud, and False Representation. Judge sentenced to 10 years, five years supervised probation, must pay $300 to Mississippi’s Crime Victim Compensation Fund, $69,232.70 in restitution to Blue Cross & Blue Shield of Mississippi jointly with co-defendants, $3,200 cost of investigation to state general fund, $2,869 in court costs. Employed with Poplarville Schools at time of crime.

● Contessa Davis, age 37, of Jackson, MS, entered an open plea (meaning she threw herself on the mercy of the court) on one count each of Conspiracy, Insurance Fraud, Mail Fraud, and False Representation.  Judge delayed sentencing to September 27 pending pre-sentence investigation. Employed with Mississippi Department of Corrections  at time of alleged crime.

● Christine Degrate, age 34, of Jackson, was employed at Jackson State University.  She plead 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 $1,795.00 for the cost of the investigation; ordered to pay $200.00 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, age 36, was employed by the Mississippi Department of Employment Security.  She plead 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 September 27, 2011, 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 $60,000.00.  The amount of restitution owed to Blue Cross & Blue Shield of Mississippi in all causes involving Johnson is $68,023.12.  Pursuant to MCA Section 7-5-309, she will also be ordered to reimburse the State of Mississippi’s General fund $2,095.00 for the cost of the investigation.

● Veronica Newell, age 43, of Jackson, formerly employed at Blue Cross & Blue Shield of Mississippi, plead 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 $4,650.00 for the cost of the investigation; ordered to pay $400.00 to the Mississippi Crime Victim’s Compensation Fund and court costs in the amount of $2692.00.  Upon her release from prison, she will serve five years of supervised probation.

● Tiana Whitsett, age 35, of Jackson, formerly employed at Blue Cross & Blue Shield of Mississippi, plead 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, age 34 of Jackson, formerly employed by MDOC, plead 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 $981.00 for the cost of the investigation; ordered to pay $200.00 to the Mississippi Crime Victim’s Compensation Fund and court costs in the amount of $2,046.00.  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’s investigation and made a prompt and full refund to the State. The Department of Audit assisted.“The defendants stole huge amounts of money and Judge Emfinger imposed 10-15 year sentences,” said Attorney General Hood.  “I hope this sends a message that if you steal, you will be caught.”The cases were prosecuted by Special Assistant Attorney General Larry Baker of the Attorney General’s Public Integrity Division.]]]]> ]]>

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