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Man sentenced to prison, ordered to pay restitution for health care fraud

A Bethesda, Md. man was sentenced February 9 to 18 months in prison for health care fraud. In addition to the prison term imposed, he was also ordered to pay $173,870.12 to the North Carolina Medicaid Fund as restitution, according to a press release from the Department of Justice, Eastern District of North Carolina.

According to court documents, Christian Anthony Ekberg, 34, was an officer and minority shareholder of an out-of-state company that entered into an agreement with a North Carolina dentist. Under the agreement, the out-of-state company would provide professional management services to the dentist, including submitting Medicaid claims, and the dentist would provide dental services to patients living in skilled nursing facilities throughout North Carolina.

“From September 2, 2015 through April 21, 2017, Ekberg, and others, knowingly submitted fraudulent dental claims to Medicaid. For example, although the dental records showed that only approximately 107 prophylaxes and 24 debridements had been performed for Medicaid recipients living at the skilled nursing facilities, claims were submitted falsely representing that 771 prophylaxes and 611 debridements were performed for these recipients,” stated the release. “In total, the health care fraud resulted in Medicaid paying approximately $173,870.12 for services that had not been rendered. These funds were deposited into an account to which Ekberg had access. During the relevant time period, Ekberg signed all the checks from this account. The checks written to Ekberg, to cash, and to the out-of-state company, totaled approximately $177,034.”

Robert J. Higdon Jr., U.S. Attorney for the Eastern District of North Carolina made the announcement after sentencing by Chief U.S. District Judge Richard E. Myers II. The North Carolina Department of Justice’s Medicaid Investigations Division (MID) investigated the case and Special Assistant U.S. Attorney Mike Heavner prosecuted the case.

The 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 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 $6,160,252 for Federal fiscal year (FY) 2020. The remaining 25 percent, totaling $2,053,414 for FY 2020, is funded by the State of North Carolina.

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