PEMBROKE, N.C. (WNCN) — Attorney General Josh Stein announced on Wednesday that Healthkeeperz, Inc., a Pembroke behavioral health care provider, will pay $2.1 million to resolve allegations that the company violated the False Claims Act by billing claims that were not reimbursable to Medicaid programs.
“When health care providers cheat the Medicaid program, they waste taxpayers’ health care resources,” Stein said in a news release. “I will hold health care providers accountable when they break the law, and I’m pleased that this defendant will be reimbursing the Medicaid program.”
Healthkeeperz Inc. provides case management services for Medicaid beneficiaries under the North Carolina Medicaid Community Alternatives Program for Disabled Adults.
The settlement resolves allegations from Jan. 1, 2016 through Oct. 31, 2019, that said Healthkeeperz submitted reimbursement claims to North Carolina Medicaid and received payments for services that were not covered by Medicaid.
“Taxpayer-funded programs like Medicaid exist to provide critical services to beneficiaries in need of care, not to fill the coffers of health care providers,” U.S. Attorney Dena J. King said in a news release. “When providers seek to divert resources from those who really need them, we will work with our state partners and use all tools at our disposal to pursue and hold accountable entities who perpetrate fraud on federal health care programs.”
This settlement was reached in partnership with the Department of Health and Human Services Office of the Inspector General and the United States Attorney’s Office for the Western District of North Carolina. The North Carolina Department of Health and Human Services, Division of Health Benefits – Office of Compliance and Program Integrity and Clinical Policy Section also provided assistance, according to the news release.
The allegations came from a lawsuit filed by a whistleblower under provisions of the federal False Claims Act and the North Carolina False Claims Act. The claims resolved by this settlement are allegations only and there has been no determination of liability.
To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.