Home Health Fraud Heats Up in Three States

Recent Medicaid home health fraud developments have been centralized to three specific states in the last few weeks, according to The National Council on Medicaid Home Care (NCMHC).

An affiliate of the National Association for Home Care & Hospice (NAHC), the National Council on Medicaid Home Care finds various home health fraud incidents occurring in Florida, Massachusetts and Illinois in the last month.

On April 1, a home health agency administrator and a home health aide in Florida were arrested for allegedly billing over $18,000 of Medicaid services that were not rendered, NAHC reports.

Both individuals were charged with various counts of Medicaid Fraud and Grand Theft, with maximum prison sentences of 25 years and 10 years, if convicted.

Also in Florida, a woman was charged on March 27 with Grand Theft, Medicaid Fraud and Employing a Provider without a Background Screening for allegedly billing over $25,000 in unauthorized services to Florida’s Agency for Persons with Disabilities Consumer Direct Care Plus program. If convicted, this individual faces a 30 year prison sensed as well as over $120,000 in fines. 

Alleged fraudulent home health billing practices were also present in the northeast.

In Massachusetts, one man pled guilty to fraudulently billing approximately $63,000 to Medicad for services not rendered on March 31.

The individual, a personal care attendant, is one out of 32 indicted personal care attendants resulting from investigations from the Massachusetts Attorney General’s office in February 2013.  

In another Massachusetts case, a woman and her son were both indicted for allegedly billing over $96,000 in personal care attendant serivices. 

Each of the cases involved allegedly falsifying timesheets for services either partially rendered, or not at all, according to NCMHC findings. 

Additional fraud activity was reported in the midwest, particularly in Illinois, which involved one case where a woman was found guilty of engaging in a scheme to commit health care fraud. 

The woman faces a maximum sentence of 10 years in prison, three years supervised release and a $250,000 fine.

View more at NAHC Report 

Written by Jason Oliva