Medicaid Criminal Investigations

The Medicaid Criminal Investigations Unit is under the direction of Special Agent in Charge Mark A. Isley. The special agents assigned within this unit are thoroughly trained in the investigation of Medicaid fraud.

The Medicaid Criminal Investigations Unit investigates fraud committed by Medicaid health care providers and the physical abuse of patients in Medicaid funded facilities. The unit also investigates embezzlement, theft, and the improper co-mingling of patients' funds in Medicaid funded facilities.

A Medicaid provider includes any individual, corporation, or other entity, and their officers and employees, paid by Medicaid for providing a health care service. By way of example, this can include ambulance and transportation companies, chiropractors, dentists, home health agencies, hospitals, laboratories, medical equipment companies, nurses, nurse aides, nursing homes, pharmacies, physicians, physical therapists, podiatrists, and speech therapists.

The Medicaid Criminal Investigations Unit works with Department of Justice Attorneys, investigators, and auditors, all of whom are trained in the complexities of health care fraud investigations and health care fraud litigation. In addition, this unit works closely with United States Attorneys, District Attorneys, Federal and State law enforcement agencies, and private insurance company fraud units.

Contact Information

Medicaid Criminal Investigations Unit
3824 Barrett Drive, Suite 100
Raleigh, NC 27609-7220
919-881-2400
Fax: 919-881-2401