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Home health care service owner gets 3 years for Medicaid fraud

  • Author: Jerzy Shedlock
  • Updated: September 28, 2016
  • Published December 11, 2015

The operator and part-owner of Anchorage home health business Good Faith Services, accused of operating in bad faith, was sentenced Friday to three years in prison for Medicaid fraud. Good Faith Services and an affiliated company were ordered to pay more than $1.5 million in fines and restitution.

Agnes Francisco, 56, ran Good Faith Services, overseeing hundreds of personal care attendants, according to witness testimony. She was described by a state witness as "money-hungry."

Assistant Attorney General Andrew Peterson said it is inconceivable that Francisco wasn't aware of the illegal practices under her supervision. In a statement she signed, she admitted, "My knowledge, and approval, of fraudulent billing in GFS contributed to a culture of criminality in GFS."

In addition to the prison sentence, Anchorage Superior Court Judge William Morse imposed a $50,000 fine and 10 years' probation on Francisco. He added a special probation condition that Francisco must pay at least $5,000 a year toward her fine.

Francisco was charged in November 2014 with one count of medical assistance fraud. Her penalties come after the state successfully prosecuted 50 of her former employees for similar crimes. Seven others agreed to less serious civil sanctions.

Good Faith Services and an affiliated business, Anchorage Adult Day Services, were sentenced Friday as well. Good Faith Services was fined $300,000 and ordered to pay $1.2 million in restitution. Anchorage Adult Day Services was fined $20,000.

Adult Day Services' criminal charge stemmed from its employment of Francisco's son, Philip Francisco, without a valid background check. The company was permanently barred from submitting Medicaid bills.

Prosecutors say Agnes Francisco and Good Faith Service's caregivers – paid by the state to help elderly and ill patients with basic tasks and chores – fraudulently billed Medicaid for work they didn't perform.

Peterson said Francisco created a culture that encouraged employees to claim work hours even when they left Alaska.

Charges against 29 employees were filed in July 2014, a number that nearly doubled as state investigators continued their efforts to go after abusers of Medicaid. Good Faith stayed in business for another four months, until the state stripped it of its authority to bill Medicaid.

Lynne Keilman-Cruz, a program manager at the Department of Health and Social Services' Senior Disability Services, said her office works to prevent the fraud for which Francisco was convicted. Several things about the practices of Good Faith caught her attention, she said.

The business' billing trends increased yearly -- increases that appeared to get steeper and steeper, Keilman-Cruz said. Caretakers were billing for services when they were out of the country, or billing for patients who had died, she said.

"I was shocked at the depth of (fraud) that we found," she said.

Questionable business practices continued even after Francisco was suspended from billing the health care program, according to Keilman-Cruz. For example, she contacted Bloom Alaska, another caretaker services business, and suggested it take all of Good Faith's patients until she "beat the charges," she testified.

Peterson said Francisco's sentence sends the right message: White-collar criminals are more likely to calculate the risk involved in their actions, and potential prison time should deter some of them, he said.

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