AG Office Charges Yet Another Medicaid Scam

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thrice
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Joined: Thu Dec 07, 2006 10:28 am

AG Office Charges Yet Another Medicaid Scam

Post by thrice » Thu May 05, 2011 8:42 pm

Star Tribune:

Two sisters who ran a Brooklyn Park home health care business are accused of fraudulently billing the state $395,577 for personal care services their company wasn't authorized to provide, according to a criminal complaint filed Wednesday in Ramsey County District Court.

In some cases, the company submitted claims stating that their employees worked more than 24 hours a day.

The case is the latest of dozens of personal care assistance fraud cases pursued since 2007 by Attorney General Lori Swanson's office, as state regulators continue to clamp down on fraud in an industry that has mushroomed in recent years in Minnesota.

Charged were Carlotta Jean Crawford-Ojo, of Brooklyn Park, and Patricia Ann Amos, of Arcadia, Calif., who operated Family Unity Support, which provided personal care assistant services to Medicaid recipients.

The charges say that between December 2007 and February 2009 the company did not have a registered nurse, licensed social worker or a mental health professional supervising the personal care assistants, which is required by Medicaid. The sisters are also accused of submitting to the state the name and license number of a nurse who applied to work for them, but was never an employee.

Each woman faces three counts of theft by false representation and two counts of identity theft.

Neither Crawford-Ojo or Amos could be reached Thursday for comment.

"Time's are tough in the state budget and any taxpayer dollar that's wasted through fraud is a serious concern," said Ben Wogsland, spokesman for Swanson's office.

In February, Swanson's office charged a Brooklyn Park couple with submitting fraudulent home care and nursing claims totaling nearly $1 million. Federal prosecutors also have brought charges against companies accused of defrauding Medicaid, known as Medical Assistance in Minnesota.

A 2009 legislative audit found hundreds of improper payments to companies that billed the state, claiming employees worked more than 24 hours in a day. A 2010 Star Tribune investigation showed that despite the state instituting changes to billing rules and limiting the hours that personal care attendants can work, violations of those rules weren't always noticed.

The investigation into Family Unity Support, which also used the name Family Unity Fiscal Agency, began more than three years ago. That's when an Anoka County investigator reported that a Medicaid recipient was receiving personal care services from his wife, an employee of Family Unity Support, in violation of Medicaid regulations, the charges said.

A Department of Human Services spokeswoman said Family Unity Support hasn't been paid by the state since February 2009 and their services were terminated by the department in February 2010.

An investigator from the Attorney General's office examined Family Unity Support's claims to the state and found several examples where the company stated an employee had worked more than 24 hours a day, including a claim for 93 hours of services in two days.

The complaint said that in 2010 an investigator asked Crawford-Ojo about the claims and she said the company billed for the number of hours listed on a timesheet as long as it had the appropriate signatures. She also said her sister's role as owner meant Amos did "everything."

Amos told an investigator that she was the CEO of Family Unity Support, but that she did not run the office.

The charges also said that a nurse who once applied for a job with Family Unity Support was listed as the supervisor, which is a position required by Medicaid. But the woman told an investigator that she never worked for the company because "what they wanted to pay me was a joke."

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