Florida Home Health Care Company Settles with State Over Medicaid Fraud Charges

Friday, September 20, 2013
By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

A Broward County, Florida, home health care company is accused of overbilling the Medicaid program for patient services by almost $500,000, according to the Sun Sentinel. This accusation comes after the Florida Agency for Health Care Administration (AHCA) conducted an audit of claims from July 2007 to March 2011. The audit allegedly found that the home health care company was overpaid for services that were not covered by Medicaid, according to the Sun Sentinel.

Click here to read the Sun Sentinel article from September 18, 2013.

According to the home health care company owner, who is also a Broward County commissioner, the company provides home health services to adults, children and infants needing medical attention.

Audit Found a Number of Issues with Claims Submitted to Medicaid.

According to the Sun Sentinel, the audit report accused the company of overcharging taxpayers for services provided to multiple patients treated at the same location, for providing private nurses to patients at the same location, and for billing rates for a registered nurse rather than a licensed practical nurse. The audit also alleges that some of the company’s medical records were incomplete, missing or lacked the proper documentation.

Owner Chooses to Settle Accusations.

The company’s owner agreed to repay the state almost $550,000 over the next three years, according to Local 10 News. The owner also agreed to pay more than $50,000 in additional fines and costs.

According to Local 10 News, the owner did not admit to any Medicaid fraud charges. In an e-mail the owner stated if there was a determination of wrongdoing it would have resulted in her home health care company being immediately terminated as a Medicaid provider. However, the company continues to provide services to Medicaid patients and receive reimbursements from Medicaid. Click here to watch the Local 10 News report.

Take Fraud Charges Seriously.

We have been consulted by many individuals similar to the subject of this story, both before and after criminal convictions for fraud or related offenses. There are many times audit investigators must make a judgment on whether overcharges are simply an honest mistake or fraud. In many instances, we are convinced that the person is actually not guilty of fraud. However, in many cases those subject to Medicaid or Medicare fraud audits and investigations refuse to acknowledge the seriousness of the matter or they decide not to spend the money required for a top quality attorney to defend them.

If you are accused of Medicare or Medicaid fraud, realize that you are in the fight of your life. Your liberty, life and profession are at stake. You need to sell everything you own, borrow everything you can and hire the absolute best criminal defense attorney available who has experience in defending such cases to represent you.

If you win and are acquitted, at least you still have a professional license and can start over. However, if you lose, you will most probably be in prison for years. You will lose your license. You will be excluded from Medicare. You will be a convicted felon. You will have nothing and will have no way of starting over successfully.

Do not delude yourself. This is extremely serious. Be prepared to give up whatever you have if you can avoid a conviction.

Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations and other Legal Proceedings.

Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Health Care Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.

The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (AFLs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.

To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.


What do you think of this settlement? Do you think this home health care company should continue to be a Medicaid provider? Please leave any thoughtful comments below.


Norman, Bob. “State: Broward vice mayor's company overcharged Medicaid nearly $500,000.” Local 10 News. (September 18, 2013). From: http://www.local10.com/news/blogs/bobnorman/state-broward-vice-mayors-company-overcharged-medicaid-nearly-500000/-/3223354/22011628/-/p06brb/-/index.html

Carney, Heather. “Broward vice mayor's company overbilled Medicaid nearly $500,000, state audit says.” Sun Sentinel. (September 19, 2013). From: http://www.sun-sentinel.com/news/broward/fl-barbara-sharief-overcharged-medicaid-20130919,0,3310096.story

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law.  He is the President and Managing Partner of The Health Law Firm, which has a national practice.  Its main office is in the Orlando, Florida, area.  www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone:  (407) 331-6620.

Tag Words: Medicaid, Medicaid fraud, Medicaid investigation, Florida Medicaid audit, Florida Medicaid, Florida Medicaid Program, Medicaid audit, Medicaid claims, fraudulent claims, Attorney General (AG), Agency for Healthcare Administration (AHCA), Medicaid Fraud Control Unit (MFCU), home health care, overbill Medicaid, Medicaid investigation, home health care company, home health care company Florida, audit of a home health care company,  defense attorney, defense lawyer, Medicaid fraud defense attorney, Medicaid fraud defense lawyer, Florida attorney, Florida lawyer, The Health Law Firm

"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
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