September 14, 2011
Jefferson City, Mo. -- Attorney General Chris Koster today announced a settlement with Southwest Center for Independent Living (SWCIL), a Springfield, Missouri, company that arranges for the provision of in-home personal care services for qualified individuals. The settlement resolves allegations that SWCIL failed to ensure that all personal care services billed to Medicaid were actually provided to Medicaid clients.
The Attorney General’s Medicaid Fraud Control Unit alleges that SWCIL submitted claims to Medicaid for in-home health services that were not provided by personal care attendant Angela Adams. Investigation revealed that SWCIL knew or should have known that Adams had not provided in-home personal care services on dozens of instances, as Adams submitted timesheets indicating she was providing services to two SWCIL clients at the same time or while the client was in the hospital.
The settlement required SWCIL to pay $43,503.72 in civil penalties and investigative costs. SWCIL also agreed to implement various quality assurance measures to ensure that the in-home personal care services billed to Medicaid are actually being provided to Medicaid recipients.
“Medicaid pays organizations like Southwest Center 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 Southwest Center 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.”
The Attorney General’s Office, together with the Greene County Prosecuting Attorney’s Office, filed criminal charges against personal care attendant Angela Adams on August 2, 2011, as a result of the above allegations. As in all criminal cases, the charges against Adams are allegations, and the defendant is presumed innocent until or unless proven guilty in a court of law.
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 firstname.lastname@example.org 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.