False Claims Act: North Carolina Health Company Pays $2.1 Million To Resolve Medicaid Billing Fraud Case
On June 1st, 2022, the United States Attorney’s Office for the Western District of North Carolina announced that Healthkeeperz, Inc.—a health care behavioral services company with a main office in Robeson County, NC—has agreed to pay more than $2 million to resolve an improper Medicaid billing case. The legal claim was initiated by a whistleblower. Here, our Florida healthcare billing fraud whistleblower rights attorney provides a more detailed overview of the False Claims Act settlement reached by the federal government.
Health Billing Fraud: Medicaid Billed for Non Reimbursable Services
The North Carolina based Healthkeeperz, Inc. provides a wide range of behavioral health services, including emotional support and spiritual support. The company works with Medicaid beneficiaries in North Carolina, providing certain case management services consistent with state law and federal law. However, the DOJ alleges that Healthkeeperz, Inc. also billed Medicaid for $2.1 million in services that were not actually eligible for reimbursement under the program.
The alleged improper billing of Medicaid occurred between early 2016 and late 2019. The DOJ determined that Healthkeeperz, Inc. knowingly or negligently submitted claims for reimbursement that were not eligible for payment. The $2.1 million settlement resolves a federal False Claims Act lawsuit and a North Carolina False Claims Act. Notably, as with many health billing fraud cases, the claim was initiated by a whistleblower.
Whistleblower Filed False Claims Act Lawsuit—Will Receive Award
Medicaid billing requirements, Medicare billing requirements, and other government health program billing requirements are notoriously complex. All health care providers that bill the government must follow the law. They can be held legally liable for fraudulent or otherwise improper billing through the False Claims Act. The federal government can initiate a False Claims Act on its own. State governments can do the same with state-level claims. However, in practice, the government often lacks the resources and knowledge to pursue false claims on its own.
The federal False Claims Act—and state false claims laws such as the North Carolina False Claims Act and the Florida False Claims Act—allow individual whistleblowers to bring a lawsuit on behalf of the government to protect the interests of taxpayers. That is exactly what occurred in this case. The whistleblower will receive an as-of-yet undisclosed portion of the settlement as award. The government did intervene in the case. As such, the whistleblower award will be between 15 percent and 25 percent of the ultimate recovery.
Set Up a Fully Confidential Consultation With a False Claims Act Lawyer
At Guttman, Freidin & Celler, we are devoted to protecting the legal rights and financial interests of whistleblowers. If you are preparing to disclose Medicare fraud, Medicaid fraud, or another type of health billing fraud, our legal team can help you navigate the False Claims Act. Contact us now for a 100 percent free initial consultation. With a main office in Miami, our whistleblower rights team provides nationwide representation in federal False Claims Act cases.