U.S. Attorney Dena J. King, along with the State of North Carolina, has leveled a serious accusation against durable medical equipment supplier Benson I. Ejindu, which has sparked a legal battle. The government's complaint, filed in the Western District of North Carolina, alleges that Ejindu was involved in "upcoding" - essentially billing Medicaid for more expensive supplies than were provided. Specifically, the claims were for specialized nutritional formulas, whereas recipients actually received common over-the-counter nutritional drinks such as Ensure and PediaSure, according to a statement from the Department of Justice.
From at least May 19, 2017, through August 23, 2019, the business operated by Ejindu is accused of knowingly causing false claims to be submitted. This involved billing for high-reimbursing products intended for individuals with rare metabolic disorders, yet providing less expensive alternatives. As U.S. Attorney King put forth, such actions by durable medical equipment providers not only waste taxpayers’ dollars but also inflate healthcare costs across the board. Her office, in collusion with North Carolina's Attorney General and law enforcement, has pledged to halt such billing malpractices.
The joint effort to investigate and address the alleged fraud involved the FBI and the Department of Health and Human Services Office of Inspector General (HHS-OIG), as well as the Medicaid Investigations Division of the North Carolina Attorney General’s Office. Special Agent in Charge Kelly Blackmon of HHS-OIG commented on the necessity for medical providers to comply with laws when billing Medicaid and the commitment to investigating improper billing submitted to federally funded health care programs.
North Carolina's reliance on Medicaid for healthcare and medical supplies underscores the potential impact of such fraudulent activities on state residents. Attorney General Jeff Jackson stated on the U.S. Attorney's Office website, "If businesses try to make an unlawful buck off of taxpayer dollars, we’ll hold them accountable," acknowledging both the importance of Medicaid to North Carolinians and the collaborative effort to eradicate healthcare fraud.
