Attorney General Jeff Jackson announced on May 5 that his office has secured $584,000 to resolve allegations of Medicaid fraud involving Crossroads, a treatment center for substance use disorders in Greensboro.
The settlement addresses concerns about improper billing practices and the misuse of taxpayer funds within the North Carolina Medicaid program. The investigation found that between 2019 and 2023, Crossroads submitted claims for urinary drug testing without allowing physicians to order less complex tests, resulting in unnecessary costs. The facility closed its clinical laboratory in 2024.
“This is the best-case scenario for addressing fraud and waste in the Medicaid program,” said Attorney General Jeff Jackson. “A managed care organization flagged something that was out of pattern, we worked with our federal partners and the U.S. Attorney’s Office for the Middle District to investigate, and the facility cooperated with us to resolve the issues and repay the Medicaid program. We’re going to protect every single dollar taxpayer dollar to ensure it goes to taxpayer healthcare.”
First Assistant United States Attorney Mike DeFranco said: “False claims undermine the integrity of the Medicaid program and waste valuable taxpayer dollars. It is the mission of this to identify and hold accountable providers that seek to enrich themselves and defraud taxpayers by submitting such claims. Together with our partners at the North Carolina Attorney General’s Office, we will continue to identify fraud and pursue justice on behalf of Medicaid.”
The irregular billing was first identified by Trillium Health Resources (formerly Sandhills Center), a managed care organization responsible for many North Carolinians’ Medicaid coverage. Trillium referred its findings through state channels before reaching investigators at Jackson’s office.
The federal and North Carolina False Claims Acts allow governments to recover triple damages plus civil penalties per false claim; however, officials note these are allegations only without judicial determination or admission of liability.
Multiple agencies participated in investigating this case: NCDOJ’s Medicaid Investigations Division (MID), U.S. Department of Health & Human Services’ Office of Inspector General, N.C. Division of Health Benefits Office of Compliance & Program Integrity as well as Clinical Policy Section, Trillium Health Resources’ Special Investigations Unit, according to the official website.
MID investigates health care provider fraud as well as patient abuse or neglect in facilities funded by Medicaid throughout North Carolina under authority granted by federal law; since inception it has recovered over $1.2 billion for restitution or penalties benefiting public programs including schools statewide according to the official website.
