Company that operates Medicaid billing system in NC accused of fraud in NY
The I-Team has discovered that the company that designed and operates the NCTracks Medicaid billing system in North Carolina is being accused of health care fraud in New York.
A criminal lawsuit, filed Monday by Preet Bharara, the U.S. Attorney for the Southern District of New York, alleges Computer Sciences Corp. (CSC) and the City of New York orchestrated a multi-million dollar Medicaid fraud scheme that lasted four years.
The complaint claims the City of New York and CSC used computer programs to automatically alter billing data in the state's Early Intervention Program.
It also accuses them of submitting tens of thousands of false claims to Medicaid that violated state laws and policies.
CSC is the same company that built and now operates the Medicaid billing system in North Carolina, NCTracks.
The program is still awaiting certification by the Centers for Medicare & Medicaid Services.
While the lawsuit makes no mention of NCTracks, it is raising concerns about the scrutiny it could face from the federal government down the road.
"If we don't get certified there could be penalties, fees," said Williams Mullen attorney Knicole Emanuel. "We could owe the federal government the money that they paid for the CSC contract. There's also a possibility that the feds just pull their dollars that come into North Carolina that pay for Medicaid. The feds pay about 60% to 65% of our Medicaid here in North Carolina and if the feds pulled that then that would be just a catastrophe to Medicaid here in North Carolina."
Williams Mullen represents providers in a civil lawsuit against NC DHHS and NCTracks for what it says are flaws in the troubled system.
"It has gotten better, but they are still complaining. There are still problems. The reimbursement rates are still incorrect in many instances," said Emanuel.
CSC denies its participation in any fraud and plans to fight back against the allegations, saying in a statement to ABC11, "We believe there is no factual or legal basis to support virtually all the allegations of which we have been made aware during the course of the inquiry, and that the complaint is without merit."
NC DHHS did not comment on whether it is looking into the NCTracks program following the New York lawsuit.
To read the lawsuit: http://www.corporatecrimereporter.com/wp-content/uploads/2014/10/US-v-CSC-and-City-of-New-York-Complaint.pdf
