Zoeller, nursing home reach agreement

Keith Loria Dec. 7, 2010, 2:46pm

INDIANAPOLIS (Legal Newsline) - Indiana Attorney General Greg Zoeller announced on Monday that he has reached a $376,432 settlement with a nursing home that allegedly defrauded Medicaid.

American Senior Communities LLC of Indianapolis allegedly submitted claims for work performed by seven employees who were not eligible in the Medicaid program.

The settlement is the largest the state has ever received in a Medicaid excluded-provider case.

"Ensuring that health care employees who serve our seniors and most vulnerable patients in the Medicaid program are qualified and worthy of people's trust is a priority of my office," Zoeller said.

"At a time when every tax dollar is precious, tracking down those ineligible to work in Medicaid in order to claw back overpayments is important and will hopefully ensure greater statutory compliance for providers in the future."

According to federal law, any health care professionals who have been convicted of various crimes are excluded from involvement in Medicaid and other federally funded health care programs.

"When companies flout the rules and employ individuals undeserving of that trust, then the state of Indiana has an obligation to investigate so that Medicaid funds wrongly paid out can be recovered," Zoeller said.

The suit alleged that the nursing and rehabilitation care company employed seven workers that the company knew or should have known were excluded from the federal health care program because of their past criminal records.

Although it denied any liability, American Senior Communities will pay a civil penalty of $376,432 for the combined federal-state recovery, with $130,040 going to the state.

The company also agreed to implement policies and procedures to prevent hiring or contracting with any person or entity excluded from Medicaid.

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