Raleigh-Area Physician Agrees to Pay $385,000.00 to Resolve Allegedly Fraudulent Medicare and Medicaid Claims

RALEIGH, N.C. –United States Attorney Michael Easley announced today that Haritha Nadendla, M.D., and Triangle Women’s Center, P.C., (hereinafter referred to as “Triangle”), an OB/GYN practice that Dr. Nadendla owns and operates in the Raleigh, North Carolina area, have agreed to pay $385,000 to settle civil False Claims Act liability concerning allegations that Triangle submitted false claims to the Medicaid program for certain patient visits.

The Government contends that it has certain civil claims against Triangle arising from Triangle’s submission of claims to the North Carolina Medicaid Program for medical services from January 1, 2018, through December 31, 2021, including claims for CPT 99215 – Evaluation & Management for an established patient in an office or outpatient location, which the Government contends were not supported by the medical record and were not medically necessary.  The Government contends that Triangle’s submission of such claims for payment to the North Carolina Medicaid Program violates the Federal and North Carolina False Claims Acts.

“This civil fraud case demonstrates our firm commitment to protect taxpayer money and to guard the integrity of federal programs,” said U.S. Attorney Michael Easley.  “Our office will zealously pursue those who misuse or abuse government funds.”

“My office’s Medicaid Investigations Division is committed to holding accountable health care providers who waste taxpayer resources,” said North Carolina Attorney General Josh Stein. “I thank U.S. Attorney Easley and his team for their continued partnership to protect Medicaid funds for North Carolinians.”

This matter was investigated by the United States Attorney’s Office for the Eastern District of North Carolina and the Medicaid Investigations Division of the North Carolina Attorney General’s Office (“MID”).  Special Deputy Attorney General Michael M. Berger, who also serves as a Special Assistant United States Attorney, represented the United States and the State of North Carolina.

The allegations were originally made in a lawsuit filed under the whistleblower provisions of both the Federal and North Carolina False Claims Act by Hannah Turnbull.  The respective False Claims Acts permit private parties to sue for false claims on behalf of the United States and the State of North Carolina, as well as potentially sharing in any recovery.  As for the recovery, the False Claims Acts allow the United States and the State of North Carolina to recover triple the money falsely obtained, plus civil penalties for each false claim submitted.

The civil claims settled by this False Claims Act agreement are allegations only; there has been no determination of civil liability.

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