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North Carolina physician, medical practice to pay $300k to resolve alleged fraudulent Medicare and Medicaid claims

Acting United States Attorney G. Norman Acker III announced April 28 that Benjamin C. Udoh and Hanora Medical Center, PLLC, an internal medicine practice that Dr. Udoh operates in Fayetteville, have agreed to pay $300,000 to settle civil claims under the Federal and North Carolina False Claims Acts concerning allegations that they submitted false claims to the Medicare and Medicaid programs for Autonomic Nervous System (“ANS”) Testing, according to a press release from the Department of Justice, Eastern District of North Carolina.

The release stated that the United States and the State of North Carolina alleged that during a four-and-a-half-year period between January 2016 to May 2020, Udoh and Hanora Medical Center submitted false or fraudulent claims for ANS Testing using current procedural terminology codes 95921, 95923, 95925, 95927, 93922 and 93923 when the testing services were not medically necessary and/or the medical record did not support medical necessity. As a result, Udoh and his medical practice allegedly received funds to which they were not entitled.

“In addition to the monetary portion of the settlement, Dr. Udoh and Hanora Medical Center have entered into an Integrity Agreement with the Office of Inspector General for the United States Department of Health and Human Services,” stated the release.

“Medical providers have a duty to provide services that are medically necessary for a patient’s care, not services that will simply help pad the provider’s wallet. Our office will continue to root out those providers who attempt to take advantage of their patients in an effort to bilk government programs. Those who fail to comply with the law in order to increase their own bottom line will be pursued by the Department of Justice,” said Acker.

The Federal and North Carolina False Claims Acts authorize the government to recover triple the money falsely obtained, plus substantial civil penalties for each false claim submitted.

“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,” stated the release.

This matter was investigated by the United States Attorney’s Office for the Eastern District of North Carolina and the Medicaid Investigations Division of the North Carolina Attorney General’s Office (“MID”). Special Deputy Attorney General Michael M. Berger, who also serves as a Special Assistant United States Attorney, represented the United States and the State of North Carolina.

The MID investigates and prosecutes healthcare 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.

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