Home Health & Hospice Week

D.C. aide billed for 32 hours of services per day.

Home health fraud isn’t limited to federal programs.

Check out these recent fraud cases around the nation that have focused on state-covered personal care services:

In North Carolina: A woman who pleaded guilty to Medicaid home health fraud has received a prison term of more than 14 years and an order to pay $13.4 million in restitution, North Carolina Attorney General Josh Stein says in a release. Latisha Harron admitted to conspiring with her husband, Timothy Mark Harron, to bill the North Carolina Medicaid program for home health services that were never provided through Agape Healthcare Services Inc., an alleged Medicaid home health provider in Roanoke Rapids. The Harrons continued to bill North Carolina after moving to Maryland and then Las Vegas, laundering the funds to pay for a private jet, North Carolina property, luxury clothing and jewelry, and more, according to the release. The Harrons used obituaries to look up deceased Medicaid recipients, then back-billed for services for up to a year before their deaths. Timothy Harron pleaded guilty to fraud charges in April and awaits sentencing.

In Nevada: A Medicaid Fraud Control Unit investi­gation based on a tip found that Senior Life Advocacy Group d/b/a Floras Personal Care Attendant, owned by Flora Siwa, was billing Medicaid for providing personal care services when the recipients were in fact hospitalized, according to a release from Nevada Attorney General Aaron D. Ford. District Court Judge Eric Johnson sentenced Floras for a gross misdemeanor offense of Failing to Maintain Adequate Records, ordered Floras PCA and Siwa to pay nearly $25,000 in restitution jointly, and placed them on probation for two years.

In Missouri: Healthy Home & Family Inc. in Farmington, an in-home health care provider, and its owners Belinda Bivens and Mary Stockson have agreed to pay more than $302,000 to settle false claims charges, Missouri Attorney General Eric Schmitt says in a release. Healthy Home and the owners admitted to submitting false claims to MO HealthNet for more hours than their attendants actually provided and to altering attendants’ timesheets to conceal the fraud. Healthy Home must undergo enhanced monitoring and oversight and submit a corrective action plan to the state, Schmitt says.

In Washington, D.C.: Folashade Adufe Horne has been sentenced to 13 months in prison after pleading guilty to defrauding the D.C. Medicaid program out of more than $370,000, which she was also ordered to repay. While being employed full time by Howard University Hospital, Horne also was employed by four different home health agencies, to which she submitted false time sheets for personal care aide services she never furnished, the DOJ says in a release. Horne claimed to work more than 20 hours in a given day on more than 200 occasions, including 28 days when she asserted that she provided 32 hours of PCA services. She also claimed to provide PCA services in the District on days when she was not even in the United States, the DOJ says.

In New Hampshire: Alerion Home Care and Wellness Solutions owner Michael Maggiacomo and Alerion employee Tina Allen have been indicted for Medicaid fraud, says New Hampshire Attorney General John Formella in a release. Maggiacomo and Allen submitted claims for home nursing services never rendered to recipients who didn’t reside at home, and then presented falsified nursing notes in a state audit, Formella says.