A Lawrenceville man who ran a Tucker medical lab has been ordered to pay back $330,000 and will spend a year in prison after admitting he helped orchestrate a Medicaid scam built on genetic tests that investigators say never happened. Averil Johnson, 47, was sentenced to a 10-year term, with one year behind bars and the balance on supervision, after DeKalb County prosecutors said his staff churned out fake patient files and slipped in bogus orders using other doctors’ names. DeKalb County Superior Court Judge Gregory Adams accepted Johnson’s guilty plea and imposed the restitution and custodial time in open court.
Sentence and restitution
According to FOX 5 Atlanta, Johnson pleaded guilty to two counts of Medicaid fraud. Judge Adams sentenced him to 10 years, with one year to be served in prison, and ordered him to pay $330,000 in restitution. Court filings and news reporting indicate the plea was accepted Tuesday and the penalties were entered at that hearing.
How investigators say it worked
Documents filed by the Georgia Attorney General’s Office state that Johnson’s company, National Healthcare Center LLC, submitted Medicaid claims for hereditary cancer risk assessment tests that were never ordered and never performed. Prosecutors say Johnson used the names and National Provider Identifier numbers of two physicians to disguise the billing activity. The indictment lists multiple claims, each paid at $1,988.69, and details several payments that correspond to the counts charged in the grand jury filing.
How the scheme unraveled
FOX 5 Atlanta reports the case cracked open after a nurse at the lab called a hotline at the Georgia Department of Community Health. That tip was forwarded to the Medicaid Fraud and Patient Protection Division, which launched the investigation that ultimately led to Johnson’s indictment and guilty plea. The sentencing comes as state officials step up pressure on questionable lab billing; a June 6 similar East Cobb indictment outlined another alleged scheme involving genetic and screening test claims without valid physician orders.
Legal notes
Johnson admitted to two counts of Medicaid fraud, although the original grand jury indictment brought numerous Medicaid-related counts along with two counts of identity fraud tied to alleged misuse of healthcare providers’ credentials under O.C.G.A. § 49-4-146.1. Charging documents from the Georgia Attorney General’s Office describe the conduct as a lab billing fraud scheme, a type of case state prosecutors have put near the top of their enforcement agenda in recent years.
