A state grand jury has indicted a nurse and her home health care business, On-Call Nursing of Alaska, on 13 felony counts of scheming to defraud and stealing more than $1.5 million from Medicaid.
The nurse and company president, Sherry Trotter, was arrested in early February and is now out on bail awaiting a hearing in state Superior Court, said Don Kitchen, director of Alaska's Medicaid Fraud Control Unit. A trial date has not been set, but pre-trial conferences are expected to continue in May.
In 2003, state and federal agencies suspended On-Call Nursing's license and removed its Medicare and Medicaid certification, citing problems with care that potentially put patients at risk for harm.
On-Call is no longer seeing patients, said Jim Gilmore, the lawyer representing Trotter. He declined further comment.
Trotter still retains her nursing license, which expires November 2006, said Dorothy Fulton, executive administrator for the state Nursing Board.
While in business, On-Call Nursing provided personal care assistance for clients, such as cooking, bathing or performing other daily services people could not do by themselves, Kitchen said. His fraud control unit audited personal care services that were billed to Alaska Medicaid between Jan. 10, 2002, and Jan. 26, 2003.
Medicaid, an insurance program for low-income people, is funded through the state and federal government.
In total, the state investigation uncovered $1,501,647 in Medicaid overpayments. The 13 counts against Trotter and On-Call Nursing charge that she and her business didn't complete assessments for patient needs before billing Medicaid.
"Somebody has to look at the person and decide what's needed," Kitchen said. "You have to have all of that done before you decide what to bill."
Other counts charge that On-Call Nursing billed for more hours than the patient assessments called for, or billed for more hours than were listed on personal care assistants' time sheets. A company that bills Medicaid must keep records for patient care, including time sheets signed by the patient and the assistant providing the care, Kitchen said.
The final charges allege that Trotter's company billed for 16 patients that didn't need and weren't eligible for personal care assistance. On-Call Nursing also was charged with double-billing Medicaid and keeping a $132,972 check that Medicaid erroneously sent the business.
The state investigation reports said that On-Call Nursing billed six patients after they had died. In one case, the company kept billing up to four months after death.
Daily News reporter Ann Potempa can be reached at 257-4581 or apotempa@adn.com.
