Medicare Compliance & Reimbursement

Why three Louisiana SNF caregivers could go to jail.

Warn your employees about the dangers of deferring to beneficiaries' billing - and personnel - requests. They could be getting in way over their head.
     
Former skilled nursing facility employees Charles Loston, Carolyn Fontenette and Johnnie Davis face multiple counts of conspiring with a patient's mother to commit Medicaid fraud, said Louisiana Attorney General Charles Foti, Jr. on July 28.
     
The mother, Mathilda Alexander, was charged with fourteen counts of Medicaid fraud for allegedly submitting claims for hours the caregivers did not work.
     
According to investigators, Alexander contracted with Acadiana Circle of Friends to provide services for her disabled sons, and according to a SNF employee, handpicked the individuals who would work with them.
     
Foti says that twice a week the former employees and Alexander signed off on falsified time sheets, which were then submitted to the SNF for Medicaid reimbursement.
     
The Department of Health and Hospitals, Bureau of Protective Services triggered the investigation after a probe into the death of one of Alexander's sons. According to the AG's office, BPS officials found that she had allegedly withheld nutritional supplements and medication from the severely emaciated victim because she was trying to find some "for free." BPS investigators questioned the surviving son and became concerned that he may be in danger.
     
Alexander has also been charged with one count of cruelty to the infirm.