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Attorney General's News Release

February 16, 2011

Attorney General Koster reaches settlement in Medicaid fraud case

Jefferson City, Mo.— Attorney General Chris Koster today announced he has entered into a Deferred Prosecution Agreement with Harvest Home Care, LLC, and its owner Cathy Ramey, under which the state will be paid $65,414.

Koster said Harvest Home Care is located in St. Louis, Missouri, and is licensed under a state plan to provide personal care services, which assist elderly or disabled individuals to continue to live on their own. In order to protect recipients and maintain the integrity of the system, the state requires companies to be licensed prior to providing these services. Koster said companies must meet stricter requirements in order to obtain a license to provide Consumer Directed Services, under which services can be provided by a close family member.

The Deferred Prosecution Agreement resolves allegations that Harvest Home Care provided Consumer Directed Services from January 1, 2010, through September 5, 2010, when the company was not licensed to do so. Although not licensed, the company advertised, solicited, and billed for these services during that period and continued to advertise these services until this agreement was reached.

The Attorney General’s Medicaid Fraud Control Unit, following a tip, began investigating Harvest Home Care, and found that personal care services were being provided by unqualified persons and then falsely billed to Medicaid in the amount of $32,707.

Harvest Home Care LLC and Cathy Ramey admit criminal liability in today’s agreement and are required to pay to the MO HealthNet Fraud Reimbursement Fund $32,707 as restitution, plus an additional sum of $32,707 as a civil monetary penalty. In acknowledging criminal liability, they also waived their right to a speedy trial and the applicable statutes of limitations. Additionally, they are required to:

  • Immediately stop advertising, soliciting, and billing for Consumer Directed Services until properly licensed to do so by the state of Missouri; and
  • Obey all laws, including but not limited to Missouri laws governing Medicaid and Medicaid payments, and to bill Medicaid in a lawful manner.

In the event that Harvest Home Care and/or Cathy Ramey fail to comply with any of the requirements of the Deferred Prosecution Agreement within the next three years, then formal proceedings may be initiated immediately by the Missouri Attorney General, resulting in the possibility of jail time, fines, criminal restitution and or civil penalties.

“One of my top priorities as Attorney General is to enforce our laws against those who cheat Missouri taxpayers by committing Medicaid fraud,” Koster said. “We will continue to search for individuals who would perpetrate this kind of fraud, and recover public money stolen from our health care system.”

Koster said citizens should report suspected Medicaid provider fraud or abuse and neglect to his Medicaid Fraud Hotline toll free at 800-286-3932, e-mail the complaint to, or complete a complaint form at the Attorney General’s Medicaid Fraud Website at

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