Home Health & Hospice Week

False timesheets in DC lead to arrest.

The feds continue to crack down on fraud in the Medicaid home care services realm.

Case in point: Authorities arrested Maryland resident Joseph Tamjong on June 30 after he was charged in federal court with defrauding the Washington, D.C. Medicaid program out of hundreds of thousands of dollars, the Department of Justice says in a release.

Tamjong is alleged to have submitted false timesheets claiming that he provided personal care services when he did not, including when he was traveling outside the United States on eight different trips, the DOJ says in the release. Between December 2014 and February 2022, Medicaid issued payments totaling more than $733,000 for personal care aide services that Tamjong purportedly provided as a personal care aide or participant-directed worker.

The arrest “marks a continued effort by the FBI, the Department of Health and Human Services’ Office of Inspector General, the District of Columbia’s Office of the Inspector General’s Medicaid Fraud Control Unit, and the U.S. Attorney’s Office to investigate and prosecute individuals who defraud the D.C. Medicaid program,” the DOJ says. “Since August 2018, 11 former personal care aides have pleaded guilty to defrauding Medicaid in the United States District Court for the District of Columbia. Six of those aides were sentenced to 13 months in prison; a seventh was sentenced to serve 15 months.” An eleventh, Susan Tingwei — a licensed attorney — is scheduled to be sentenced later this month. (See more details of Tingwei’s case in HCW by AAPC, Vol. 30, No. 44).

Other Medicaid fraud developments include:

In Pennsylvania: Two personal care attendants and a biller have been sentenced in the sprawling Moriarty Consultants Medicaid fraud case in Pittsburgh. Among other crimes, aides Tiffhany Covington and Luis Columbie-Abrew stopped using their own names as the attendant on timesheets and instead used the names of “ghost” attendants, some of whom permitted their names to be used in exchange for a kickback, the DOJ says in a release. Columbie-Abrew also admitted causing the submission of hundreds of thousands of dollars of Medicaid claims for services to consumers who lived in the Pittsburgh area, despite the fact that he lived in Georgia. Biller Julie Wilson, at Arlinda Moriarty’s behest, collected information about consumers who had “unused” aide care hours, provided lists of such consumers and their unused hours to Moriarty, then would submit claims in bulk for the unused hours without the consumers’ knowledge or consent. Wilson then would send a list of those billed hours for creation of back-dated timesheets to document the purported care, DOJ says. “Rampant document fabrication also occurred during the course of state audits of the Moriarty-related entities,” the DOJ reminds. Covington was sentenced to 15 months in prison and restitution of more than $245,000. Columbie- Abrew and Wilson received three years’ probation including one year and six months of home confinement, respectively. Columbie-Abrew was ordered to repay nearly $165,000 and Wilson was ordered to repay more than $2,000.

In North Carolina: A federal judge sentenced Home Care Coordinators owner Lindsey Allison Kerns to nearly four years in prison for stealing more than $1 million from two elderly clients in her care, says the DOJ. Kerns also must repay nearly $1.1 million in restitution. Kerns overcharged her clients “by a million dollars and bought trucks, ATVs, expensive clothing and went on lavish vacations,” says FBI Agent Robert R. Wells in the release. “This is a case of greed and abuse of trust.” Because Kerns charged $1.5 million for $376,992 worth of care, she charged her 86- and 90-year-old clients nearly $1.1 million for services that were never provided. When investigated, Kerns lied to federal agents and fabricated business records and invoices,

In Massachusetts: After a three-day trial, a state court jury found the purported recipient of bogus personal care attendant services guilty of Medicaid fraud, the Office of Attorney General Maura Healey says in a release. Abdikadir Maow’s attendant was billing and getting paid for PCA hours supposedly provided during times when the attendant was working at another job or while the attendant or Maow were traveling or residing out of the country, separately, for long periods of time. Maow was sentenced to one year in jail, followed by three years of probation and $112,000 in restitution. He also can no longer participate in the PCA program and must receive services from a home health company, Healey’s office says.

In Idaho: An aide employed by Mountain Home agency A-1 Home Health Care has been sentenced to three years’ probation, 200 hours of community service, and ordered to pay $1,623 in restitution plus court costs, says a release from state Attorney General Lawrence Wasden. Tracee Taylor worked for the Mountain Home School District and Life Care Centers of America during times she reported she provided services to her A-1 clients, Wasden says.

In Tennessee: A Memphis aide has been arrested on charges that she billed TennCare for overlapping shifts when employed by three different home care agencies, the Tennessee Bureau of Investigation says in a release. An investigation into Angelia Randolph started when the Tennessee Department of Human Services Adult Protective Services provided information that Randolph had left a client unattended in a car for several hours while caring for another patient.