Raleigh doctor facing federal charges in $46 million Medicare fraud case

RALEIGH, N.C. (WTVD) -- A doctor who helped lead the COVID-19 response for the Durham County Health Department has been indicted by a federal grand jury after an investigation of her private practice.

Dr. Anita Jackson lives in Raleigh's Brier Creek. She operates several ear, nose and throat offices between Lumberton and Rockingham. It's the location of those offices, in more rural parts of the state, which may have been the red flag for federal investigators. The question: How did Jackson become the nation's top-paid provider of a special sinus-relief procedure when she doesn't practice near any major metropolitan areas? Federal prosecutors say the answer is fraud.

A federal grand jury handed up a 20-count indictment this week -- charging Jackson in a massive Medicare fraud scheme. Federal prosecutors allege between 2014 and 2018, Jackson used her practices at Greater Carolina Ear, Nose, and Throat in Lumberton, Rockingham, and other eastern North Carolina locales to bill Medicare for more than $46 million. The indictment says Jackson's practice generated more than $5.4 million.

Jackson allegedly billed Medicare for performing more than 1,200 balloon sinuplasties. It's a procedure to treat chronic sinus infection where a balloon is inflated in the patient's nasal passages to increase airflow and drainage.

The device is supposed to be a single-use device. But prosecutors say Jackson racked up profits by re-using it multiple times on multiple patients -- without telling them.

READ MORE: See the full 36-page indictment (.pdf)

The indictment also alleges Jackson deceived her patients, convincing them they owed little to no insurance co-pay so that Jackson could bill Medicare the full amount and make millions.

Prosecutors say Jackson tried to hide the scheme by falsifying billing records.

Jackson's resume on Linked In says she played an integral role in Durham County's COVID-19 response; citing an Ivy League education with degrees from Harvard, Princeton and Stanford. She was medical and laboratory director at Durham County Department of Public Health. She was also one of Gov. Roy Cooper's appointees to the North Carolina Medical Care Commission.

ABC11 spoke to Jackson's attorney on the phone Thursday. He called the charges "bogus" and "an evil prosecutorial indictment."

A spokesperson for Durham County told ABC11 that Jackson is not a current employee at the Department of Public Health.

ABC11 has not heard back from the state's Medical Care Commission on whether Jackson still holds her seat on the panel.

Jackson is charged with adulteration of medical devices, 10 counts of paying illegal remunerations, three counts of making false statements relating to health care benefits, two counts of aggravated identity theft, three counts of mail fraud, and conspiracy.

If convicted, she faces a maximum term of imprisonment of 20 years for mail fraud and up to 10 years on other charges. Jackson also faces fines exceeding $250,000.
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