[co-author: Stephanie Kozol]*
North Carolina Attorney General Josh Stein and the U.S. Attorney’s Office for the Middle District of North Carolina have reached a $500,000 settlement with Sharon Raynes Halliday and RAPHA Healthcare Services LLC, resolving a false claims lawsuit filed in July 2022 related to requests for payment submitted to the North Carolina Medicaid program.
According to the allegations, from May 15, 2015, through August 29, 2018, Halliday wrote prescriptions for controlled substances while working at RAPHA without having the appropriate prescribing authority. Regulators alleged that Halliday used a limited medical school faculty license that had been previously issued to her and submitted invoices to the North Carolina Medicaid program for payment for the medication that was not properly prescribed.
Under the federal and North Carolina False Claims Acts, the governments may recover up to three times the amount of money falsely obtained, in addition to significant civil penalties for each false claim submitted. The civil claims resolved by this settlement are allegations only, and there has been no formal finding or admission of liability by the parties involved.
The case was investigated and prosecuted through the collaborative efforts of the U.S. Attorney’s Office for the Middle District of North Carolina, the U.S. Drug Enforcement Administration (DEA), and the Medicaid Investigations Division (MID) of the North Carolina Attorney General’s Office. The settlement concludes the litigation filed jointly by the U.S. and the State of North Carolina on July 17, 2022, in the U.S. District Court for the Middle District of North Carolina.
Why It Matters
This is not the MID’s first settlement, having reached a $500,000 settlement with Active Systems under a related theory in February 2023. This settlement highlights the ongoing joint efforts of federal and state authorities to address health care fraud under state and federal false claims acts. The resolution of this case emphasizes the importance of ensuring that health care providers adhere to proper guidelines and regulations when prescribing controlled substances and seeking reimbursement from the government.
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*Senior Government Relations Manager
