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Woman charged with Medicaid fraud

Posted: April 17, 2013 - 4:24pm

State prosecutors have charged a Homer woman with two counts of medical assistance fraud. Heather Platter, 31, was charged late last month, the Alaska Department of Law, Medicaid Fraud Control Unit, announced in a press release.

In the first count, a class C felony, Platter is alleged to have knowingly submitted a claim with reckless disregard that she was not entitled to services or a benefit. In the second count, a class A misdemeanor, she is alleged to have knowingly made a false entry on a medical assistance record.

According to a criminal complaint, between Sept. 16 and Dec. 29, 2012, Platter is alleged to have falsely entered 145 hours of work on her time sheets, resulting in a loss to Medicaid of about $3,400. Platter worked as a personal care attendant, or PCA, through ResCare, a national company that coordinates what are called Consumer Direct Medicaid payments. Jackie Buckley, the Anchorage executive director of ResCare, which has offices in Anchorage and Homer, reported what appeared to be fraudulent billing to the fraud control unit, the complaint said.

Through the Consumer Direct plan, people who qualify for personal care assistance can hire personal care attendants through companies like ResCare or Consumer Direct Personal Care, another Homer company. The companies hire personal care attendants and pay wages. Attendants have to receive at least half of the $24 an hour paid to the coordinating company, said assistant attorney general Andrew Peterson of the Medicaid Fraud Control Unit. PCAs generally earn about $13.50 to $17.50 an hour, he said. Beyond criminal penalties for fraud, companies also can be barred from billing Medicaid if they commit fraud — an incentive to report fraud, Peterson noted.

The idea of the Medicaid assistance is to give people extra care so they can live as independently as possible and don’t have to live in more expensive nursing homes or assisted living homes, Peterson said.

According to the complaint, fraud unit investigators examined Platter’s timesheets and spoke to the woman for whom she worked as a PCA. The woman said she became concerned when Platter started arriving to work late and didn’t total weekly hours on her timesheet. The woman reviewed the timesheets and pointed out alleged discrepancies, such as that Platter actually worked one weekend day but billed for 16 weekend days between Sept. 16 and Dec. 29, 2012, and that she billed for a day when the woman’s husband was present and she did not need service.

When fraud unit investigators confronted Platter, the complaint said she admitted to fraudulently billing Medicaid. Platter said she was financially stressed.

Buckley and ResCare did not return a phone message from the Homer News requesting comment. Platter was not arrested, but received a summons. She will be arraigned at 9 a.m. Tuesday at the Homer Courthouse.

 

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collie
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collie 04/25/14 - 01:41 pm
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Sunlight needed

There really needs to be sunlight on the Kenai Peninsula's assisted living home industry and specifically ResCare.

41% of area residents are elderly or close to it. That's a skewed statistic. That isn't natural aging of historic Peninsula residents. That's the million-dollar personal care services industry bringing patients and clients to the area for admission into the assisted living homes that sprouted up everywhere.

ResCare has an alarming reputation across the country. It's the single largest provider of personal care services and the biggest ownership of assisted living homes. Including in Alaska.
Rescare (also known as Ready Care, Job Ready, and Southern Home Care Services) is international, owned by a private equity firm in Toronto.

"The company has come under fire in Florida, Indiana and New Mexico, where there is a moratorium on placing any new residents in ResCare facilities because of serious health and safety issues. … But what concerns advocates...is that despite numerous warning signs over the years, state regulators have continued to let ResCare expand — to the point that even if regulators needed to close ResCare’s facilities, there wouldn’t be enough other group homes to take in their clients.”
WFAA-TV (Dallas News 8), February 8, 2001
News 8 investigates ResCare Part II

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