[co-author: Stephanie Kozol]
On February 1, North Carolina Attorney General Josh Stein announced that his Medicaid Investigations Division reached a $500,000 settlement with Joint Active Systems, Inc. (JAS). The AG’s Medicaid Investigations Division “investigates and prosecutes health care providers that defraud the Medicaid program, patient abuse of Medicaid recipients … and misappropriation of any patients’ private funds in nursing homes receiving Medicaid funds.”
The investigation against JAS involved allegations of false claims to the North Carolina Medicaid, violating both the federal and North Carolina False Claims Act. Specifically, the AG alleged that between 2012 and 2021, JAS bypassed the North Carolina Medicaid regulations by causing orthotic and prosthetic providers to submit false or fraudulent claims of its “range-of-motion JAS EZ devices … to be improperly claimed as custom-fabricated orthotics” to Medicaid on JAS’s behalf.
AG Stein’s press release also noted that “[t]he federal and North Carolina False Claims Acts authorize the governments to recover triple the money falsely obtained, plus substantial civil penalties for each false claims submitted.” Funded by federal and state grants, the Medicaid Investigations Division has recovered more than $1 billion in restitution and penalties for North Carolina.
Why It Matters
Medicaid serves the most vulnerable patients through taxpayer funding. As such, regulators — especially state AGs — are keen on combatting Medicaid fraud to protect consumers in their states.
