TDFP EXCLUSIVE: Raleigh Lab That Paid $2.1 Million to Settle Medicaid False-Claims Allegations Hires a New Lobbyist on 'CMS Coding and Billing'
Mako Medical, the Raleigh, N.C., laboratory company that paid North Carolina $2.1 million in 2024 to settle allegations that it billed Medicaid for medically unnecessary urine drug tests, has hired a new Washington lobbyist, according to a federal lobbying registration reviewed by The Digital Free Press.
The registration was filed by Prospering Solutions, LLC, formerly known as John C. Snyder III, a lobbying practice based in Charlotte. It was signed and posted to the federal lobbying database on Monday, Oct. 26, at 1:07 p.m., and lists an effective date of the same day.
The filing describes Mako Medical as a "Healthcare information" company and lists a single lobbying issue: "CMS coding and billing." CMS is the Centers for Medicare & Medicaid Services, the federal agency that runs Medicare and oversees the state-run Medicaid programs, and that sets the billing codes and payment rates labs use to get paid for tests. The filing names one lobbyist, John Snyder.
The one-page registration does not say what changes to coding or billing rules Mako wants, and lobbying registrations are not required to list specific requests. It does not yet report any payments; the firm's first quarterly report covering Mako is not due until January.
Mako Medical's Lobbying History
The new contract is not Mako's first. Two firms registered to lobby for the company in 2021, during the COVID-19 testing boom, according to the federal database.
Tiber Creek Group reported $140,000 in lobbying income from Mako in 2021 on issues related to the Food and Drug Administration and COVID funding, and Linchpin Strategies reported $280,000 from the company for work on COVID response and testing policy before ending its registration in February 2023.
This spring, Mako hired a third firm. Checkmate Government Relations registered on April 14, 2026, to lobby for Mako Medical Laboratories LLC on "Issues related to medicare payment for lab services," and reported contacts with CMS and the Department of Health and Human Services. Checkmate reported $40,000 from Mako in the first quarter and $80,000 in the second, then filed a termination report listing June 1, 2026, as the end of its work.
In all, lobbying firms have reported about $540,000 in income from Mako since 2021, according to the filings. The new registration means Mako again has a lobbyist in Washington after nearly five months without one on the federal record.
Snyder's practice lists more than 20 other active clients in its latest quarterly reports, many of them health care, defense and North Carolina organizations, including Converge Medical Technology, Cresilon, Federal Injury Centers, Career Start and the NC Submarine Foundation.
The 2024 Medicaid Settlement
On March 28, 2024, then-North Carolina Attorney General Josh Stein announced that Mako Medical Laboratories, LLC had agreed to pay $2.1 million "to resolve allegations" that it submitted false claims to the state's Medicaid program.
According to the attorney general's office, the state alleged that from Jan. 1, 2018, through Dec. 31, 2022, Mako ran both presumptive and definitive urine drug tests on the same samples, and that the definitive testing was not medically necessary. The case was investigated by the office's Medicaid Investigations Division.
The announcement noted that "the civil claims resolved by settlement here are allegations only, and that there has been no judicial determination or admission of liability."
"Labs that receive Medicaid funds need to be responsible stewards of taxpayer dollars," Stein said at the time. "When they waste health care resources, my office will hold them accountable. I'm pleased that the Medicaid program will get these funds back."
The Digital Free Press found no news coverage of the new registration before publication.
Images: Downtown Raleigh skyline, by Jmalljmall, Wikimedia Commons, public domain; Centers for Medicare & Medicaid Services headquarters, Woodlawn, Md., by Carol M. Highsmith, Library of Congress, public domain.
Yossi Schmidt, Founder and Editor-in-Chief, The Digital Free Press
Hold Everyone Accountable.
Sources: Lobbying registration (LD-1), Prospering Solutions, LLC FKA John C. Snyder III for Mako Medical, posted Oct. 26, 2026: https://lda.gov/filings/public/filing/ff4a948d-6549-4d4f-a536-99c8416c1e1b/print/ ; Checkmate Government Relations registration for Mako Medical Laboratories LLC, posted April 14, 2026: https://lda.gov/filings/public/filing/856d794e-d5a2-4ec4-a20b-e37821185cf6/print/ ; Checkmate Q1 2026 report ($40,000): https://lda.gov/filings/public/filing/d7a2c753-f7af-4209-b663-aee388e2214c/print/ ; Checkmate Q2 2026 termination report ($80,000, terminated June 1, 2026): https://lda.gov/filings/public/filing/b3f3d959-0865-439e-bac1-776c90085f5a/print/ ; Tiber Creek Group registration for Mako Medical, 2021: https://lda.gov/filings/public/filing/3075f330-ce4d-45a5-b37c-465476ce26c8/print/ ; Linchpin Strategies registration for Mako Medical Laboratories, 2021: https://lda.gov/filings/public/filing/15355033-4e9a-4782-afc2-a60442230c17/print/ ; Linchpin Strategies termination report, 2023: https://lda.gov/filings/public/filing/8be3e009-167f-4e6f-95f3-6cee720780ff/print/ ; Federal lobbying database, client "Mako Medical": https://lda.gov/api/v1/filings/?client_name=Mako+Medical ; North Carolina Department of Justice, "Attorney General Josh Stein Reaches $2.1 Million Medicaid Settlement with Mako Medical," March 28, 2024: https://ncdoj.gov/attorney-general-josh-stein-reaches-2-1-million-medicaid-settlement-with-mako-medical/
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