4th Circuit Affirms Convictions in Medicaid Fraud and Kickback Scheme

A jury verdict finding defendant Donald Booker liable for his role in billing North Carolina's Medicaid program for millions of dollars' worth of medically unnecessary drug tests was upheld by the 4th Circuit. Booker owned and operated United Youth Care Services, which carried out the scheme. The evidence supported Booker's conspiracy and illegal kickbacks' convictions, the court found. Booker's argument that the evidence supporting his conspiracy conviction is insufficient was rejected, as the jury heard abundant evidence of his role in setting the company's drug-testing policies and paying illegal kickbacks to Delores Jordan.

Key Takeaways:

• Booker's conspiracy conviction was upheld, as the jury found him liable for the acts of his co-conspirators in pursuit of their common plot.
• The evidence supporting Booker's convictions for paying illegal kickbacks to Jordan was sufficient, including testimony from multiple witnesses that Booker negotiated kickback deals and authorized each payment.
• Booker's argument that the Anti-Kickback Statute violates the nondelegation doctrine was rejected, as the statute allows the Department of Health and Human Services broad discretion to promulgate regulations.
• Booker's money-laundering convictions were also upheld, as he hid the nature of the kickback payments and structured payments to avoid financial reporting requirements.
• Booker's claims of error in the admission of testimony regarding his personal bank account and bank representative's testimony were rejected.
• Booker's challenges to his downward-variant sentence were also rejected, as the district court's finding of a loss of at least $9.5 million was supported by evidence.

Statistics:

• The Medicaid program was billed for millions of dollars' worth of medically unnecessary drug tests.
• Booker was convicted on 10 counts arising from the scheme.
• The evidence showed that Booker paid over $500,000 in kickbacks to Delores Jordan.
• The scheme resulted in damages of at least $9.5 million.
• Booker was sentenced to a downward-variant sentence.

Sources:

• United States v. Booker, Case No. 23-4612, July 22, 2025.
• 4th Cir. (Diaz), from WDNC at Charlotte (Bell).
• William David Auman for Appellant.
• Amy Elizabeth Ray for Appellee.
• VLW 025-2-275.