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Home Care Workers Facing Federal Charges of Defrauding Medicaid

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Home Care Workers Facing Federal Charges of Defrauding MedicaidLast week federal prosecutors announced that six individuals were indicted and facing charges of defrauding Medicaid services. The prosecutors in the case told reporters that these six were either out on vacation, at a casino, or working other jobs when they reported on Medicaid billing timesheets that they were providing home health care services to a number of clients.

Benita Bell, 46 and Tammara Bell, 28, claimed that Benita Bell was working when she was actually at a local casino. It’s unclear what role Tammara Bell played in this fraud and it’s too early in the investigation to speculate whether she was a client receiving these services or an accomplice.

Regina Brown, 58, was allegedly providing care services to James Smith, 75, when she was actually on a cruise ship while on vacation in New Orleans. Federal prosecutors noted that Mr. Smith was a part of the fraud by helping to make claims that Ms. Brown was providing these services.

There were two other defendants named in this fraud case, though it wasn’t made clear what connection, if any, they all had to one another. According to The St. Louis Post-Dispatch news article, Feds: Home health care workers were actually gambling, cruising when billing Medicaid, written by Robert Patrick:

“Nova Paden, 50, and Demagio Smith, 27, were working elsewhere when they claimed to be either receiving or providing home health care services, prosecutors said. Smith was in New Jersey and California part of the time, the U.S. attorney’s office said. Paden was also lying about her income and falsely receiving disability payments, they said.

“Home health care is not only a more convenient alternative to skilled nursing facilities, it also saves tax dollars because it is less expensive,” said William Woods, head of the local office of the FBI, one of the agencies that investigated the case, in a prepared statement. “People who abuse and cheat the system siphon money away from those who truly need the services.”

While the federal government has been working tireless in recent years to curtail Medicare and Medicaid fraud, CMS (Center for Medicare and Medicaid Services) has been proposing a new rules change that would require in home health care workers to submit for approval of specific services before providing those services.

It’s unclear whether this new rule change would have impacted this fraud case and no other information regarding court dates or potential plea deals were released at this time.

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