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South Carolina man convicted of defrauding state Medicaid of over $1 million despite not having clients

Jonathan W. Sumter will now have to pay the money back as restitution in addition to serving more than 7 years in prison.
Credit: Micha? Chodyra
Photo: Thinkstock

COLUMBIA, S.C. — Prosecutors say a South Carolina man claimed to be providing behavioral health services to disabled, low-income people. But details released during his recent trial suggest he actually used the stolen identities of nearly 200 people with disabilities to game the system of over $1 million in Medicaid funds.

The U.S. Attorney's Office District of South Carolina announced on Friday that 51-year-old Jonathan W. Sumter of Greer was sentenced to 7 years in prison for a scheme that netted a big payout at the expense of numerous victims.

According to prosecutors, Sumter operated a company known as PHC Supportive Services that claimed to offer rehabilitative behavioral health services through the Medicaid program. 

But investigators soon learned that the company had no clients despite billing South Carolina Medicaid over $1 million for services it never provided.

Instead, prosecutors said Sumter and his PHC company used stolen National Provider Identifier numbers of nine healthcare professionals in order to invoice the Medicaid program. He then used the stolen identities of 196 Medicaid members "with severe mental and emotional health disorders" without them even knowing.

Caregivers and clients were later contacted by investigators and confirmed they had not received services from PHC or its founder. Service providers confirmed the same when asked if they had used Sumter's services.

In Friday's announcement, U.S. Attorney Adair Boroughs took a strong stance against Sumter's actions.

“Using stolen identities of the most defenseless people to steal money from the hard-working people of South Carolina is unacceptable.," Boroughs said.

Boroughs added that the U.S. Attorney's Office would continue to "aggressively prosecute" offenders who steal from programs designed to provide care to vulnerable citizens.

Sumter now faces 92 months in prison and will be required to repay $1,055,373.66 in restitution to South Carolina Medicaid.

“This sentence warns bad actors in the behavioral healthcare field that South Carolina has citizens in need of these services," Attorney General Alan Wilson said. "Any fraudulent conduct that abuses these programs or prevents our citizens from receiving needed services will not be tolerated."

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