South Raleigh News

Attorney General Josh Stein has announced a $2.1 million Medicaid settlement with Mako Medical after an investigation revealed improper billing practices by the company. Stein emphasized the importance of holding labs accountable for their use of taxpayer dollars, stating, “Labs that receive Medicaid funds need to be responsible stewards of taxpayer dollars. When they waste health care resources, my office will hold them accountable. I’m pleased that the Medicaid program will get these funds back.”

According to the investigation, between January 1, 2018, and December 31, 2022, Mako allegedly conducted both presumptive and definitive urine drug tests (UDTs) on the same sample for health care providers. The state asserted that the definitive testing was not medically necessary or reasonable under North Carolina Medicaid policy, resulting in Mako receiving reimbursement for funds it was not entitled to.

The settlement with Mako Medical was reached as part of the ongoing efforts of the Medicaid Investigations Division of the North Carolina Attorney General’s Office to combat healthcare fraud. It is important to note that the civil claims resolved by the settlement are allegations only, and there has been no judicial determination or admission of liability.

The Medicaid Investigations Division (MID) plays a crucial role in investigating and prosecuting healthcare providers who defraud the Medicaid program. The MID has a track record of success, having recovered over $1 billion in restitution and penalties for North Carolina. Individuals can report Medicaid fraud or patient abuse in North Carolina by contacting the MID at 919-881-2320.

Funding for the MID comes from both the U.S. Department of Health and Human Services and the State of North Carolina, totaling $8,535,748 and $2,845,248 respectively for Federal fiscal year 2023. This financial support enables the MID to continue its efforts to protect the integrity of the Medicaid program and ensure that taxpayer dollars are used appropriately.