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Attorney General's News Release

October 24, 2011

Attorney General Koster reaches settlement in Medicaid fraud case -- Company to pay state $130,000 --

Jefferson City, Mo.— Attorney General Chris Koster today announced a settlement with Midland Empire Resources for Independent Living (MERIL), a St. Joseph, Missouri, based company that provides in-home personal care services. The settlement requires the company to pay the state $130,000 and resolves allegations that MERIL failed to ensure personal care services that were billed to Medicaid were actually provided to clients.

The Attorney General’s Medicaid Fraud Control Unit (MFCU) investigated MERIL following a referral from the Missouri Department of Health and Senior Services. As a result of the investigation, MFCU alleges that MERIL submitted numerous claims to Medicaid for in-home health services that were not provided, and that MERIL either knew or should have known that its attendants had not provided the services. The attendants submitted timesheets indicating that services were being provided while the clients actually were institutionalized or while the attendants were working at other places of employment.

“Medicaid pays organizations like Midland Empire Resources for Independent Living to ensure Medicaid in-home personal care services are delivered and billed appropriately,” Koster said. “I am committed to ensuring that the dollars used in the Medicaid program are used to provide necessary healthcare, and that every dollar is accounted for. I appreciate the cooperation of the Midland Empire Resources for Independent Living in this matter and I am pleased that they have agreed to implement new quality assurance measures to help ensure accurate billing.”

Koster said the settlement requires MERIL to pay $32,470 in restitution; $64,940 in damages; $25,000 in civil penalties; and $7,590 for investigation costs, totaling $130,000. Koster said MERIL and his office developed quality assurance measures that MERIL will implement to ensure that services billed to Medicaid are being provided to Medicaid recipients.

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://ago.mo.gov/divisions/medicaid-fraud-control-unit-faqs.htm.



 
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