Attorney General Josh Stein today announced a $500,000 settlement to resolve allegations that Sharon Raynes Halliday and RAPHA Healthcare Services LLC submitted false claims to the North Carolina Medicaid program.
"We are battling a national opioid crisis," said Attorney General Josh Stein. "When providers write unauthorized prescriptions for controlled substances, they’re wasting taxpayer dollars and jeopardizing public health. I thank the federal government for their partnership in holding these providers accountable."
From May 15, 2015, through August 29, 2018, Halliday allegedly wrote prescriptions for controlled substances under RAPHA without appropriate authorization or authority. She reportedly used a limited medical school faculty license issued to her.
The federal and North Carolina False Claims Acts allow governments 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 this settlement are allegations only, with no judicial determination or admission of liability.
The investigation and prosecution were conducted by the United States Attorney’s Office for the Middle District of North Carolina, the United States Drug Enforcement Administration (DEA), and the Medicaid Investigations Division (MID) of the North Carolina Attorney General’s Office. The settlement resolves a civil lawsuit jointly brought by the United States and North Carolina on July 17, 2022, in the United States District Court for the Middle District of North Carolina.
The MID investigates and prosecutes healthcare providers defrauding Medicaid, patient abuse of Medicaid recipients or any patient in facilities receiving Medicaid funding, and misappropriation of patients’ private funds in nursing homes receiving Medicaid funding. To date, it has recovered more than $1 billion in restitution and penalties for North Carolina.
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 totaling $8,535,748 for Federal fiscal year (FY) 2023. The remaining 25 percent is funded by North Carolina.