Clayton man who submitted $1 million in false Medicaid claims to spend nearly 6 years in prison

North Carolina news

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RALEIGH, N.C. (WNCN) — A Clayton man who submitted more than $1 million in false Medicaid claims will spend nearly six years in prison, state Attorney General Josh Stein said Thursday.

A federal judge also ordered Luis Angel Lozada to pay $1.1 million in restitution.

Stein also said Humberto Mercado was sentenced to 15 months in prison and ordered to pay nearly $500,000 in restitution.

“We count on health care providers to take care of us and our loved ones,” Stein said in a statement. “Unfortunately, some providers are more focused on lining their pockets and will go to great — and illegal — lengths to do it. My office will hold accountable anyone who defrauds Medicaid and wastes taxpayer resources.”

Lozada, who formed a behavioral health business in 2016 in Zebulon, pleaded guilty in September 2020 in federal court to submitting more than $1 million in false and fraudulent reimbursement claims between 2016-20 for services that were never provided.

Mercado, who pleaded guilty to conspiracy to commit health care fraud, fabricated treatment records before the first billings were submitted to Medicaid.

Two other men who also pleaded guilty were previously sentenced.

The investigation and prosecution of this case was conducted by the U.S. Attorney for the Eastern District of North Carolina along with the FBI and the state Department of Justice’s Medicaid Investigations Division.

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