WILMINGTON — An investigation by the state medical board resulted in additional reprimands for a Wilmington doctor who was ordered to repay $1.25 million in false Medicaid charges last year.
In July, the North Carolina Medical Board (NCBM) issued a consent order for Wilmington doctor Dorothy Ejinkonye Agbafe-Mosley of the Ave Maria Family Practice. The order officially reprimands Dr. Agbafe-Mosley and prohibits her from prescribing Schedule I and Schedule II drugs, which includes most opioid painkillers (a notable exception is codeine). The order also requires Agbafe-Mosley to complete a competency assessment.
The order is a result of an NCBM investigation into Agbafe-Mosley’s quality of care. The investigation found that the quality of care delivered by Agbafe-Mosley was consistently below the state standard, including a failure to maintain proper drug safety.
NCBM began the investigation after it was notified of a separate investigation, launched by Attorney General Josh Stein’s Medicaid Investigations Division.
The AG’s investigation found Agbafe-Mosley was using higher billing codes than appropriate for addiction medicine services. Stein’s office also found that Agbafe-Mosley was billing for services that weren’t medically necessary, lacked appropriate clinical documentation, or violated Medicaid policy. Stein made a point of noting that wasting Medicaid resources for those dealing with addiction during the ‘opioid epidemic’ required his office to hold doctors accountable. Agbafe-Mosley was ordered to repay $1.25 million to Medicaid.
Given the allegations against Agbafe-Mosley, NCMB also focused on the ‘quality of care,’ which unlike improper billing, is outside the purview of the AG’s Medicaid Investigations Division. The board selected the records for four of Agbafe-Mosley’s patients and submitted them for two separate independent reviews, one to examine her billing practices and one to consider quality of care.
The medical coding expert reported concerns about the potentially improper use of “high level services on a routine basis” for the four patients, as well as evidence that Agbafe-Mosley was “cloning” her patient care notes.
The quality of care review, performed by a family medicine expert, found that the overall care for all four patients was “below the appropriate standard of care in North Carolina.”
The specific findings included the following
- Agbafe-Mosley’s pharmacovigilance (a.k.a. drug safety) and pain management care was below the appropriate standard of care in North Carolina
- Agbafe-Mosley’s medical documentation was below the appropriate standard of care in North Carolina
- Agbafe-Mosley generally displayed an overall lack of attention to general family practice patient care issues in areas that included diabetes, coronary artery disease, kidney disease, pulmonary disease, hypertension, and atrial fibrillation
The consent order does not bar Agbafe-Mosley from practicing medicine in general. The order will remain in effect indefinitely until removed by NCMB. Any violation of the order would constitute grounds for NCMB to annul, suspend, or revoke Agbafe-Mosley’s license.
Agbafe-Mosley NC Medical Board Consent Order – Port City Daily by Ben Schachtman on Scribd
