Tuesday, November 18, 2014
Attorney general announces Medicaid fraud settlement with health care provider
Attorney General Chris Koster announced today that he has reached a settlement with Independent Home Care, Inc., of St. Louis, and the company's owner, Sharlene Scruggs, for submitting false claims to MO HealthNet, Missouri's Medicaid program. The agreement requires Scruggs and her business to pay the state $224,616.
Koster said that Independent Home Care provides services to Medicaid participants under two of MO HealthNet's in-home programs. An investigation by Koster's Medicaid Fraud Control Unit revealed Scruggs and her company failed to ensure that the personal care attendants employed by the company were actually providing the services to the Medicaid participants as they claimed. In some instances, Scruggs and her company billed for services to Medicaid participants in their homes during times when those participants were actually hospitalized. In other instances, Scruggs and her company billed MO HealthNet for more services than employees claimed to have provided. Independent Home Care received $87,654 from MO HealthNet as reimbursement for the false claims.
Under the terms of the settlement agreement, Scruggs and Independent Home Care will pay the MO HealthNet Fraud Reimbursement Fund $87,654 for restitution and $136,962 for damages and penalties.
"My office will continue to aggressively investigate evidence of Medicaid fraud and stop those who illegally take scarce health-care dollars out of the system," Koster said.
Koster said citizens should report suspected Medicaid provider fraud or abuse and neglect to his Medicaid Fraud Hotline toll free at 800-286-3932, e-mail the complaint email@example.com or complete a complaint form online.