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Healthcare-10
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

A Bethesda, Md., man was sentenced for his role in a scheme that defrauded the North Carolina Medicaid program out of more than $175,000. Christian Anthony Ekberg, 34, was an officer and minority shareholder of an out-of-state company that had a business partnership with a North Carolina-based dentist.

Ekberg’s company provided professional management services to the dental practice, such as handling billing for Medicaid patients. The dentist practice primarily provided care to patients living in skilled nursing facilities throughout the state. (Isn’t it just like a fraudster to exploit the elderly?)

Ekberg used his position to submit fraudulent dental claims to Medicaid from September 2, 2015 through April 21, 2017. Dental records showed that only 107 prophylaxes (a measure to maintain health and prevent the spread of disease) and 24 debridements (a procedure to remove debris or infected tissue) had been conducted on skilled nursing facility residents during that time. Despite this, Ekberg submitted fraudulent claims stating that 771 prophylaxes and 611 debridements were performed. (Fraudsters never let the truth stand in the way of getting what they want.)

The North Carolina Medicaid program paid $173,870.12 in reimbursements for services that had not been rendered. These funds were deposited into an account Ekberg used to write checks to himself. He endorsed the checks to the out-of-state company he controlled. The checks Ekberg wrote totaled approximately $177,034. (I can only imagine the checks were written out ‘to me, for me, and with love from me’.)

Ekberg was sentenced to 18 months in prison for healthcare fraud.(The judge didn’t buy a ‘I’m just not so good at math’ excuse.)  In addition to the prison term imposed, he was also ordered to pay $173,870.12 to the North Carolina Medicaid Fund as restitution.

Today’s Fraud of the Day comes from a Department of Justice press release, ”Man Sentenced for Health Care Fraud in Excess of $175,000,” dated February 9, 2021.

WILMINGTON, N.C. – A Bethesda, Maryland man was sentenced today to 18 months in prison for health care fraud.  In addition to the prison term imposed, he was also ordered to pay $173,870.12 to the North Carolina Medicaid Fund as restitution.

According to court documents, Christian Anthony Ekberg, 34, was an officer and minority shareholder of an out-of-state company that entered into an agreement with a North Carolina dentist.  Under the agreement, the out-of-state company would provide professional management services to the dentist, including submitting Medicaid claims, and the dentist would provide dental services to patients living in skilled nursing facilities throughout North Carolina.

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