North Carolina AG Settles $150K Medicare Fraud Claim With Health Care Provider

Troutman Pepper

[co-author: Stephanie Kozol]

North Carolina Attorney General Josh Stein announced that he reached a $150,000 settlement with Rockingham health care provider Compassionate Counseling Services (Compassionate) for allegedly submitting false claims to the North Carolina Medicaid program from June 7, 2016 to January 8, 2021.

AG Stein claimed that Compassionate billed for diagnostic assessments either backdated or not properly signed/dated by the required professionals. Since Compassionate lacked the proper documentation to show the services’ necessity or to support the assessments, it must return $150,000 to the North Carolina Medicaid program per the settlement.

Why It Matters

This settlement follows other enforcement actions brought by AG Stein against health care providers over false billing practices. In February 2023, AG Stein reached a $500,000 settlement with Joint Active Systems, Inc. over allegations of false claims to the North Carolina Medicaid. Since Medicare and Medicaid serve vulnerable patients through taxpayer funding, regulators, especially state AGs, are keen on combatting fraud involving these two fundamental institutions to protect states’ consumers.

 

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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