Mo. AG settles with two in-home care companies

Bryan Cohen Oct. 24, 2011, 1:15pm


JEFFERSON CITY, Mo. (Legal Newsline) - Missouri Attorney General Chris Koster announced settlements on Monday with two in-home personal care services companies that will pay the state approximately $717,420 for alleged Medicaid-related violations.

Midland Empire Resources for Independent Living, based in St. Joseph, allegedly submitted numerous claims to Medicaid for in-home health services that were not provided, including timesheets indicating that services were being provided while clients were institutionalized or while attendants were working at other places of employment.

Delmar Gardens Private Services allegedly submitted claims for reimbursement for in-home services provided by in-home service workers to immediate family members when its workers were ineligible to provide such services in addition submitting claims to Medicaid for reimbursement when services could not have been provided because the clients were admitted to a nursing home or hospital or the DGPS employee was working at another place of employment.

The first settlement requires MERIL to pay $32,470 in restitution, $64,940 in damages, $25,000 in civil penalties and $7,590 for investigation costs, totaling $130,000. MERIL and Koster's office have developed quality assurance measures that the company will implement to ensure services billed to Medicaid are being provided to Medicaid recipients.

"Medicaid pays organizations like MERIL to ensure Medicaid in-home personal care services are delivered and billed appropriately," Koster said. "I am committed to ensuring that the dollars used in the Medicaid program are used to provide necessary healthcare, and that every dollar is accounted for. I appreciate the cooperation of the MERIL in this matter and I am pleased that they have agreed to implement new quality assurance measures to help ensure accurate billing."

The settlement with DGPS requires the company to pay $579,920 in restitution and civil penalties and $7,500 in court costs. DGPS has also agreed to implement various quality assurance measures, including mandatory employee training and enforcement of internal policies.

"Medicaid pays companies like Delmar Gardens to ensure Medicaid in-home services are delivered appropriately, and it is the responsibility of this office to make sure the companies follow the law." Koster said. "From the outset of the investigation, Delmar Gardens fully cooperated with this office and took steps to make sure they are in full compliance in the future."

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