Complaint charges provider with upcoding for nutrition formulas


CHARLOTTE, N.C. – The United States and the State of North Carolina have filed a complaint against Benson I. Ejindu alleging he knowingly submitted or caused to be submitted false claims to North Carolina Medicaid for more expensive medical supplies than were actually provided to the Medicaid recipients, a practice known as upcoding. From at least May 19, 2017, through August 23, 2019, Ejindu, through a DME business that he operated under different names, allegedly caused the submission of false claims to North Carolina Medicaid for high-reimbursing, specialized nutritional formula for individuals with rare, inherited metabolic disorders when he knew the Medicaid recipients actually received lower-reimbursing Ensure, PediaSure, Boost and Glucerna drinks. “Durable medical equipment providers that cause the government to pay more than it should for medical equipment and supplies waste taxpayers’ dollars and raise the cost of health care for everyone,” said Dena J. King, U.S. Attorney for the Western District of North Carolina. “Our office is committed to working with the North Carolina Attorney General’s Office and our law enforcement partners to put a stop to improper billing practices that exploit Medicaid, a taxpayer funded program that many people depend on to cover their health care needs.” The matter is being investigated by the FBI, HHS-OIG and the North Carolina Attorney General’s Medicaid Investigations Division. The claims asserted against Ejindu are allegations only and there has been no determination of liability.


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