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DHCF Applauds Joint Effort by US Attorney and FBI to Eliminate Fraud in the Medicaid Home Health Program

Thursday, February 20, 2014
(Washington, DC) – DHCF Applauds Joint Effort by United States Attorney and Federal Bureau of Investigation to Eliminate Fraud in the Medicaid Home Health Program
Today, the United States Attorney’s Office (USAO) announced that arrest warrants have been executed against persons associated with four Medicaid home health care agencies and one case management organization.  The arrest warrants allege a range of offenses including improper billing for Medicaid personal care services for persons who require assistance with the basic activities of daily living.
This action was the result of years of investigative work by federal officials whose efforts were aided by the surveillance activities of the Department of Health Care Finance (DHCF).  All four home health agencies that were served with arrest warrants had been previously referred for suspicious billing patterns by DHCF to the Medicaid Fraud Control Unit within the Office of the Inspector General (OIG).  As indicated below, these referrals began in 2009 and ended in 2011.  This speaks to the length of time allocated to these investigations.  During this period, DHCF has worked closely with the Office of the Inspector General OIG to pursue these cases.
Home Health Company                             Date Referred
Global Health Care Services                      12/4/2009
Ultra International                                      9/21/2009
Vizion One                                                    4/19/2010
American Quality                                         4/11/2011
“We are pleased to learn that federal officials have initiated arrest warrants against home health care providers who are believed to have perpetrated significant acts of Medicaid fraud in the District’s personal care program,” said DHCF Director Wayne Turnage. “DHCF highlighted the agency’s growing concern with the unexplained and rapidly increasing cost of the personal care program in 2011 and has been working on a number of initiatives to address this serious problem since that time.  The actions by federal officials today will be of tremendous assistance as we move forward with additional reforms to the personal care program.”
DHCF’s priority is to continue our surveillance and fraud detection efforts to protect the integrity of the system so that we can be sure that people who are truly in need get the services they deserve.