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Wednesday, October 16, 2024

Health care fraud settlement returns $625K to state and federal programs

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Attorney General Josh Stein | Official website

Attorney General Josh Stein | Official website

Attorney General Josh Stein has announced a settlement of $625,000 with Dr. Eric Troyer and his medical practice, Troyer Medical Inc, P.C., based in Landis. The settlement addresses allegations of a laboratory kickback scheme. The funds will be distributed to state and federal health care programs, with $429,254 going to the federal government and $195,746 to North Carolina.

"Doctors need to make decisions based on what’s best for their patients, not based on what puts more money back in their own pockets," said Attorney General Josh Stein. "I’m pleased that these funds are being returned to the people. My office will not allow health care providers to waste taxpayer resources."

Between August 2015 and November 2021, Dr. Troyer and his practice allegedly received kickbacks from a laboratory in Anderson, South Carolina. These payments were reportedly disguised as an analyzer, office space rental, and phlebotomy fees.

The alleged actions led to false or fraudulent claims submitted to Medicare, Medicaid, and TRICARE under the False Claims Act. Dr. Troyer has agreed to cooperate with ongoing investigations by the United States Department of Justice into other participants involved in these schemes.

The investigation was conducted by several agencies including the United States Department of Justice, the United States Attorney’s Office for the District of South Carolina, the Office of Inspector General of the United States Department of Health and Human Services, the Defense Criminal Investigative Service, the Federal Bureau of Investigation (FBI), and North Carolina's Medicaid Investigations Division (MID).

The MID is responsible for investigating fraud against Medicaid programs and patient abuse within facilities receiving Medicaid funding. To date, it has recovered over $1 billion in restitution and penalties for North Carolina.

For those wishing to report Medicaid fraud or patient abuse in North Carolina, contact can be made via phone at 919-881-2320. The MID receives 75% of its funding from a U.S. Department of Health and Human Services grant totaling $8,535,748 for fiscal year 2024; the remaining 25%, amounting to $2,845,248 for FY 2024 is provided by North Carolina.

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