Crime & Courts

Home-health provider owes state $1.5M for Medicaid fraud crimes

Alaska home-health business Good Faith Services has pleaded guilty to a single count of medical assistance fraud. As part of a plea agreement, the corporation will pay $1.5 million in penalties.

The business's primary owner, Agnes Francisco, and another provider, Anchorage Adult Day Services, also entered guilty pleas for fraud on Friday.

Good Faith was charged several months after dozens of its caregivers paid by the state to help elderly and ill Alaskans with basic tasks and chores fraudulently billed the health program for work they did not perform.

Charges against 29 individuals were filed in July. The state had never before filed that many fraud charges in a single day, prosecutor John Skidmore said at that time.

Good Faith initially was not charged alongside its employees. The 6-year-old company remained in business. But in November 2013, the state stripped it of its billing privileges.

Since the initial flood of charges, the state has filed criminal charges for medical assistance fraud against 53 individuals associated with Good Faith Services, including 13 members of its 16-member office staff, according to Andrew Peterson, head of the Office of Special Prosecution's Medicaid Fraud Control Unit.

The unit's investigation found 10 of those employees billed Medicaid nearly $400,000 for services they claimed to be providing "while simultaneously working in the office," Peterson said. And Good Faith also billed about $1 million for services provided by personal care attendants before the attendants were given the OK by the Alaska Department of Health and Social Services.

ADVERTISEMENT

In a number of the cases, sons and daughters were providing the care for their parents, which is allowed under the Medicaid rules. Some of the questioned billings came for time periods when the caregiver was working another job or when either the caregiver or the care recipient were out of the country, the charges show.

Most of the charges arise from billings for services that never were provided to residents of Chugach Manor and Chugach View, apartments for low-income seniors in East Anchorage.

The plea agreement with Good Faith calls for the business to pay a fine of $300,000 and $1.2 million in restitution.

Three owners are responsible for paying the money owed to the state. When the state froze payments to Good Faith, $600,000 was headed to the company. There will be roughly $450,000 that still needs to be paid, Peterson said.

"There are two individuals associated with Good Faith who are not being charged as part of the agreement," he said. "They are responsible for paying off that balance in five years."

Francisco will be permanently barred from billing Medicaid. She lacks the finances to pay, Peterson said.

Good Faith will cease to exist. The corporation must be permanently dissolved, according to the Department of Law. It "will no longer be providing Medicaid services."

As for Francisco, the court will determine her sentence for a single count of attempted medical assistance fraud. An agreed upon aggravator -- a feature of her crimes that makes them worse – allows for a jail term of five years, which is above the presumptive range of zero to two years.

Adult Day Services, the separate health care entity, pleaded to misdemeanor medical assistance fraud. The charge stems from the company allowing Francisco's son, Philip Francisco, to work for them without a valid background check. It will be permanently barred from submitting Medicaid bills.

Jerzy Shedlock

Jerzy Shedlock is a former reporter for Alaska Dispatch News. He left the ADN in 2017.

ADVERTISEMENT