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Attorney General's News Release

June 29, 2011

Attorney General Koster reaches settlement in Medicaid fraud case -- Company to pay state $74,000 --

Jefferson City, Mo.— Attorney General Chris Koster today announced a settlement with Smith & Associates Home Care, a Hayti, Missouri, based company that provides in-home personal care services. The settlement resolves allegations that Smith & Associates failed to ensure personal care services were properly delivered to its Medicaid clients.

The Attorney General’s Medicaid Fraud Control Unit investigated and prosecuted Crystal Abernathy, a Smith & Associate’s employee, for submitting false claims to Medicaid for personal care services she did not provide to a Medicaid recipient, her ex-mother-in-law. Abernathy pled guilty to the charges in March 2011. The investigation revealed that Smith & Associates had sufficient evidence, starting in August 2007, that Abernathy was not providing the hours claimed on the timesheet. Also, because Abernathy was allegedly providing services to her ex-mother-in-law, Smith & Associates should have been more diligent in scrutinizing the timesheets before billing Medicaid.

“Medicaid pays companies like Smith & Associates to supervise and ensure Medicaid personal care services are delivered appropriately. In this case, the company failed to carry out its duties,” Koster said. “There was sufficient evidence in this case that Smith & Associates should have paid closer attention to the hours Abernathy claimed she worked. I am committed to holding the companies responsible for doing what Medicaid pays them to do – make sure the services are provided properly.” Today’s agreement requires Smith & Associates to pay $69,067.03 in restitution and damages, and $5,000.00 for investigation costs, totaling $74,067.36. This agreement is a compromise of disputed claims and does not contain an admission of wrongdoing by Smith & Associates.

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 attorney.general@ago.mo.gov or complete a complaint form at the Attorney General’s Medicaid Fraud Website at http://www.ago.mo.gov/divisions/medicaid-fraud-control-unit-faqs.htm.



 
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