Home-health business loses billing privileges in wake of fraud probe

dkelly@adn.comNovember 28, 2013 

An Alaska home-health business where dozens of caregivers are being investigated for Medicaid fraud has been temporarily stripped of its billing privileges, state officials said Wednesday.

Charges leveled against 39 caregivers with Good Faith Services, an Anchorage-based personal assistance program, include felony and misdemeanor accusations of medical assistance fraud. The program is intended to help people stay in their homes rather than entering a nursing home or assisted living facility, and to help with basic tasks like dressing and bathing.

In a number of cases, prosecutors say, caregivers billed the state for work they never did. When the investigation was first announced in July, the state said the Alaska Medicaid program paid out more than $362,000 in fraudulent billings to 29 individuals.

Further investigation expanded the probe to 39 caregivers, said John Skidmore, director of the criminal division in the Alaska Department of Law. So far, 10 people have been convicted and sentenced, 23 are still in court and six have yet to appear before a judge, Skidmore said.

On Monday, the Alaska Department of Health and Social Services suspended the company's Medicaid billing privileges. State health department rules require Medicaid billing to be suspended if a business has a credible allegation of fraud against it and is being investigated for Medicaid fraud.

The suspension is temporary but it could become permanent if charges are brought against the company that lead to a criminal conviction. At this point, Good Faith Services has not been charged with fraud.

"(The state) felt it was important enough, and enough employees implicated, that they needed to put a halt" to the billing privileges, said Cori Mills, a spokeswoman for the Alaska Department of Law.

Good Faith Services has appealed the suspension, according to a statement released Wednesday by the state health department. A lawyer for Good Faith Services, Chester Gilmore, did not immediately respond to a request for comment.

The cases include accusations of caregivers billing for services that were never provided, or pressuring Medicaid recipients to sign up for services.

The most recent set of charges came in October, when the Department of Law charged caregiver Barbara J. Kanehailua, 60, of Anchorage with allegedly fraudulently billing Medicaid $94,339 over 29 months. The state said an investigation showed Kanehailua worked as a caregiver for seven different companies at the same time, and an audit of her time sheets showed she was working more than 24 hours a day.

In 2012, Kanehailua's time sheets show she worked 311 days and averaged 29 hours a day, prosecutors said.

Reach Devin Kelly at dkelly@adn.com or 257-4314.

 

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