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Attorney General Josh Stein Announces $1.25 Million Medicaid Settlement

For Immediate Release:
Friday, November 22, 2019

(RALEIGH) Attorney General Josh Stein today announced he reached a $1.25 million settlement with a Wilmington family medicine physician, Dr. Dorothy Agbafe-Mosley, and her medical practice, Ave Maria Family Practice PLLC, to resolve allegations involving the submission of false claims for addiction treatment to the North Carolina Medicaid program.

“The opioid epidemic has devastated North Carolinians,” said Attorney General Josh Stein. “We need to make sure people who need treatment medications get them. My office will hold providers accountable when they waste Medicaid resources meant for people who need health care.”

According to the settlement, between Jan. 1, 2015, and Dec. 31, 2018, Agbafe-Mosley submitted medical claims on behalf of herself and her practice involving addiction medicine services allegedly provided to Medicaid recipients. These services were not medically necessary, had no supporting clinical documentation, or were performed in violation of Medicaid policy. Agbafe-Mosely has agreed to pay back $1.25 million to the Medicaid program.

This settlement was obtained with the assistance of the NCDOJ’s Medicaid Investigations Division, and the North Carolina Department of Health and Human Services’ Division of Health Benefits – Clinical Policy and Program Integrity.

About the Medicaid Investigations Division (MID)

The Attorney General’s MID investigates fraud and abuse by healthcare companies and providers, as well as patient abuse and neglect in facilities that are funded by Medicaid. Medicaid is a joint federal-state program that helps provide medical care for people with limited income. To date, the MID has recovered more than $850 million in restitution and penalties for North Carolina.

To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.

Contact:
Laura Brewer (919) 716-6484

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