Missouri Attorney General Chris Koster announced a settlement Sept. 14 with Springfield-based Southwest Center for Independent Living, a company that arranges for in-home personal care services.
The settlement resolves allegations that the company 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 alleged that Southwest Center for Independent Living submitted claims to Medicaid for in-home health services that were not provided by SCIL attendant Angela Adams.
An investigation revealed that the company knew or should have known that Adams had not provided in-home personal care services in numerous instances, as she submitted time sheets that indicated she was providing services to two clients at the same time or while a client was in the hospital, according to a news release from Koster’s office.
Additionally, the attorney general’s office, together with the Greene County prosecuting attorney’s office, filed criminal charges
against Adams on Aug. 2 as a result of the allegations, though the case has yet to move to trial.
The terms of the settlement require Southwest Center for Independent Living to pay $43,503 in civil penalties, as well as the costs of investigation. The company also agrees to implement quality assurance measures to ensure that in-home personal care services billed to Medicaid are actually being provided to Medicaid recipients, the release said.
“Medicaid pays organizations like Southwest Center for Independent Living to ensure Medicaid in-home personal care services are delivered and billed appropriately,” Koster said in the release. “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.”