ASHEVILLE, N.C. – U.S. Attorney Dena J. King announced today that Pembroke, North Carolina based behavioral healthcare provider, Healthkeeperz, Inc. (Healthkeeperz), has agreed to resolve allegations that the company violated the False Claims Act by billing claims to Medicaid programs that were not reimbursable under the applicable North Carolina Medical Clinical Coverage Policy. Healthkeeperz has agreed to pay $2.1 million to resolve the allegations.
Healthkeeperz provides case management services for Medicaid beneficiaries under the North Carolina Medicaid Community Alternatives Program for Disabled Adults (CAP/DA). The settlement resolves allegations that from January 1, 2016, through October 31, 2019, Healthkeeperz submitted reimbursement claims to North Carolina Medicaid and received payment based on those claims for services that were not covered by Medicaid.
“Taxpayer-funded programs like Medicaid exist to provide critical services to beneficiaries in need of care, not to fill the coffers of healthcare providers,” said U.S. Attorney King. “When providers seek to divert resources from those who really need them, we will work with our state partners and use all tools at our disposal to pursue and hold accountable entities who perpetrate fraud on federal healthcare programs.”
“Protecting taxpayer resources requires strong partnership between the states and the federal government,” said North Carolina Attorney General Josh Stein. “I appreciate U.S. Attorney King’s partnership. When we work together, we can hold accountable health care providers who break the law.”
The allegations arose from a lawsuit filed by a whistleblower under the qui tam provisions of the federal False Claims Act and the North Carolina False Claims Act. Under the False Claims Acts, private citizens can bring suit on behalf of the government for false claims and share in any recovery. The act also allows the government to intervene and take over the action. The government conducted the investigation and intervened in this action to effectuate the settlement.
The settlement is a result of a coordinated effort between the Department of Health and Human Services Office of the Inspector General, the North Carolina Attorney General’s Medicaid Investigations Division, and the United States Attorney’s Office for the Western District of North Carolina.
The lawsuit resolved by this settlement is United States and the State of North Carolina ex rel. Ginger L. Hill v. Healthkeeperz, Inc. (1:20CV32). The claims resolved by this settlement are allegations only and there has been no determination of liability.