Winterville man pleads guilty to Medicaid fraud conspiracy

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A Winterville man and president of a local behavioral health practice pleaded guilty in federal court Thursday to conspiracy to commit health care fraud and perjury. 

Shepard Lee Spruill II, 46, of Winterville, faces up to 15 years in prison, $500,000 in fines and three years of supervised release, according to U.S. Attorney for the Eastern District of North Carolina John Stuart Bruce in a news release.

Under additional terms discussed in court, Spruill agreed to make restitution in the amount of $1,846,377 to the North Carolina Medicaid program, as well as additional restitution for any other fraud committed by or through Medicaid providers Pride in North Carolina, Carolina Support Services, Elite Care, Southern Support Services, One to One Youth, Vision of New Hope, Bridge Builders Youth Services, and Jameson Consultants.

According to the criminal information and evidence discussed in open court, Spruill entered into conspiracy with Terry Lamont Speller and Donnie Lee Phillips II, both of whom are already imprisoned, to defraud Medicaid in connection with a clinic in Pitt County, known as “The Medical Office.”

Spruill, who at that time was the president of a behavioral health practice named Carolina Support Services, had access to lists of patient names and Medicaid identification numbers. Spruill provided these to Speller and Phillips, who used them to fraudulently bill Medicaid for more than $2 million in fictitious services. After Medicaid sent payment for the fake services to Speller, Spruill received his cut of the proceeds under the guise of loan repayments.

With respect to the charge of perjury, the evidence showed that Spruill testified before a federal grand jury that he had no business relationship with Speller, and that he had no knowledge of why Medicaid payments were being split between Speller and Spruill. Under the plea agreement, Spruill admitted that he lied about these facts to the grand jury.

Speller, 38, is imprisoned at the Cumberland Federal Corrections Institute in Maryland and is scheduled to be released on Nov. 25, 2032, and Phillips, 28, is imprisoned at Beckley Federal Correctional Institute in West Virginia and is scheduled to be released on July 18, 2023.

The investigation of this case was conducted by agents of the N.C. Bureau of Investigation assigned to the Medicaid Investigations Division of the North Carolina Attorney General’s Office; the Internal Revenue Service – Criminal Investigation; and the U.S. Department of Health and Human Services Office of the Inspector General.

The investigation and prosecution of this matter is being handled in a partnership between the U.S. Attorney’s Office for the Eastern District of North Carolina and the Medicaid Investigations Division of the N.C. Attorney General’s Office. Assistant U.S. Attorney William M. Gilmore of the Economic Crimes Division and Special Assistant U.S. Attorney Daniel Spillman of the Medicaid Investigations Division of the N.C. Attorney General’s Office, represented the United States.