For Immediate Release:
Wednesday, June 1, 2022
Nazneen Ahmed (919) 716-0060
(RALEIGH) Attorney General Josh Stein today announced 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,” said Attorney General Josh Stein. “I will hold accountable health care providers when they break the law, and I’m pleased that this defendant will be reimbursing the Medicaid program. I appreciate U.S. Attorney King’s partnership to protect these resources for North Carolinians.”
“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,” said U.S. Attorney Dena J. King. “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.”
Healthkeeperz provides case management services for Medicaid beneficiaries under the North Carolina Medicaid Community Alternatives Program for Disabled Adults (CAP/DA). The settlement resolves allegations that from January 1, 2016, through October 31, 2019, Healthkeeperz submitted reimbursement claims to North Carolina Medicaid and received payments for services that weren’t covered by Medicaid.
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. The allegations arose from a lawsuit filed by a whistleblower under the qui tam 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.
About the Medicaid Investigations Division (MID)
The Attorney General’s MID investigates fraud and abuse by health care companies and providers, as well as patient abuse and neglect in facilities that are funded by Medicaid. Medicaid is a joint federal-state program that helps provide medical care for people with limited income. To date, the MID has recovered more than $900 million in restitution and penalties for North Carolina.
The Medicaid Investigations Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $6,160,236 for Federal fiscal year (FY) 2022. The remaining 25 percent, totaling $2,053,412 for FY 2020, is funded by the State of North Carolina.
To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.