For Immediate Release:
Thursday, March 28, 2024
Contact:
Nazneen Ahmed (919) 716-0060
(RALEIGH) Attorney General Josh Stein today announced that he reached a $2,100,000 settlement to resolve allegations that Mako Medical Laboratories, LLC submitted false claims to the North Carolina Medicaid program. Mako is headquartered in Raleigh and operates a clinical laboratory performing, among other things, urine drug testing (“UDT”).
“Labs that receive Medicaid funds need to be responsible stewards of taxpayer dollars,” said Attorney General Josh Stein. “When they waste health care resources, my office will hold them accountable. I’m pleased that the Medicaid program will get these funds back.”
Between January 1, 2018, and December 31, 2022, Mako allegedly offered health care providers the option to order both presumptive and definitive UDTs. A presumptive test detects the general presence of a substance, and a definitive test determines the precise amounts of a substance.
For providers who ordered both tests, Mako performed them on the same sample at or near the same time, for the same or similar substances, often providing overlapping information for presumptive and definitive UDTs. The state alleges that this definitive testing was not medically necessary or reasonable under North Carolina Medicaid policy, and that as a result, Mako was reimbursed for funds that it was not otherwise entitled to receive.
The investigation and prosecution of this case was conducted by the Medicaid Investigations Division of the North Carolina Attorney General’s Office as part of its continuing data mining efforts to identify and prosecute healthcare fraud. It should be noted that the civil claims resolved by settlement here are allegations only, and that there has been no judicial determination or admission of liability.
About the Medicaid Investigations Division (MID)
The Attorney General’s MID investigates and prosecutes health care providers that defraud the Medicaid program, patient abuse of Medicaid recipients, patient abuse of any patient in facilities that receive Medicaid funding, and misappropriation of any patients’ private funds in nursing homes that receive Medicaid funding. To date, the MID has recovered more than one billion ($1,000,000,000.00) dollars in restitution and penalties for North Carolina. To report Medicaid fraud or patient abuse in North Carolina, call the MID at 919-881-2320.
The MID receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $8,535,748 for Federal fiscal year (FY) 2023. The remaining 25 percent, totaling $2,845,248 for FY 2023, is funded by the State of North Carolina.
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