A behavioral health provider in Lumberton, North Carolina, Southeastern Behavioral Healthcare Services, LLC, along with its owners Bertha and Virgil Hutchinson, has agreed to settle accusations of Medicaid fraud by paying over $2.5 million, U.S. Attorney Michael F. Easley, Jr. revealed yesterday. As part of the settlement, Southeastern will also enter an Integrity Agreement with the Office of Inspector General of the United States Department of Health and Human Services, which mandates ongoing compliance.
The joint investigation by the Federal and State Governments alleges that from March 2016 through July 2020, Southeastern and the Hutchinsons submitted false claims to Medicaid for services not provided. Some patients were reportedly incarcerated, or even deceased, on the dates billed. "This is yet another example of the U.S. Attorney’s Office and the North Carolina Attorney General’s Office working together to proactively pursue fraud in our publicly-funded healthcare programs," said U.S. Attorney Easley in a statement obtained by the Justice Department's website. These allegations, while resolved with the settlement, have not resulted in a judicial admission of liability.
Multiple government entities contributed to the investigation, including the Eastern District of North Carolina's U.S. Attorney’s Office, Health and Human Services' Office of Inspector General, and the Medicaid Investigations Division of the North Carolina Attorney General’s Office. Special Deputy Attorney General Matthew R. Petracca represented the Governments and the State of North Carolina in this matter.
Kelly Blackmon, Special Agent in Charge of HHS-OIG, stated, "Medical providers are required to strictly adhere to the law when billing Medicaid for services.” She further asserted HHS-OIG's determination to investigate improper billings to federally funded health care programs. The Federal and North Carolina False Claims Acts empower the Governments to seek triple the funds falsely obtained, plus significant civil penalties for each false claim submitted. Attorney General Josh Stein echoed the sentiment on the responsible stewardship of Medicaid dollars, acknowledging the joint efforts to combat healthcare fraud.
