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Missouri Attorney General Obtains $150,000 Medicaid Fraud Settlement

Jun 25, 2021, 14:36 PM by AG Schmitt
Today, Missouri Attorney General Eric Schmitt announced that his office’s Medicaid Fraud Control Unit has obtained a $150,000 settlement against a former Poplar Bluff Medicaid provider for falsely billing services that weren’t provided.

“My Office’s Medicaid Fraud Control Unit works tirelessly to root out, investigate, and prosecute instances of Medicaid fraud across the state of Missouri,” said Attorney General Schmitt. “In order to protect taxpayer dollars and ensure that people are getting the care they need, my Office will continue to aggressively pursue those who attempt to game the Medicaid system for personal gain.”
 
The settlement, which was entered in early June, was with Brook Fears. Fears owned and operated Shady Oaks Retirement Home, a residential care facility in Poplar Bluff.  She filed 148 false claims with MO HealthNet for personal care and nursing services that her facility did not provide to six Medicaid recipients from January 1, 2018 through June 23, 2019. The Shady Oaks Retirement Home is no longer in service.
 
Fears will pay $150,000 to the MO HealthNet Fraud Reimbursement Fund, including full restitution of $106,615.42 and $43,384.58 in penalties.  She could not produce documentation to prove certain services were provided, including:

  • Plans of care for the recipients,
  • Daily service logs of personal care services received including dates, times, list of tasks performed and descriptions and signatures of the recipients, and
  • Written notes by a nurse regarding on-site visits or annual personal care aide assessments.

The case was investigated by De’Nel Holliday and prosecuted by Assistant Attorney General Brad Crowell.
 
The Missouri MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $2,818,808 for Federal fiscal year 2021. The remaining 25 percent, totaling $939,601 is funded by the State of Missouri.

 
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