On December 10, 2024, North Carolina Attorney General Josh Stein announced an $825,000 settlement with The Carter Clinic over allegations of health care fraud. The clinic, based in Raleigh, was accused of improperly billing Medicaid for urine drug testing and other services between January 1, 2020, and May 27, 2024.
Attorney General Stein stated, “Health care providers can’t waste taxpayer dollars to put more in their own pockets.” He emphasized that his office would hold accountable those who defraud the Medicaid program.
The allegations against The Carter Clinic include ordering frequent and repetitive definitive urine drug tests without adjusting the level of testing or considering patients' treatment progress. These tests were claimed to be neither medically necessary nor reasonable. Additionally, the clinic allegedly failed to obtain test results in a timely manner and did not document some billed peer support services.
Under the Federal and North Carolina False Claims Acts, governments can recover triple the amount falsely obtained plus civil penalties for each false claim. It is important to note that these claims are allegations only; there has been no judicial determination or admission of liability.
The investigation was conducted by the Medicaid Investigations Division (MID) of the North Carolina Attorney General’s Office. This division is responsible for identifying and prosecuting health care fraud related to Medicaid.
The MID has recovered over one billion dollars in restitution and penalties for North Carolina so far. To report Medicaid fraud or patient abuse in North Carolina, individuals can contact the MID at 919-881-2320.
Funding for the MID comes primarily from a grant awarded by the U.S. Department of Health and Human Services, covering 75 percent of its budget for Federal fiscal year 2025. The remaining funding is provided by the State of North Carolina.