Monday, February 9, 2015

KCK woman sentenced to prison, restitution for home health care fraud

KANSAS CITY, KAN. ----- A Kansas City, Kan., woman working as a personal care attendant was sentenced in U.S. District Court last week for health care fraud based on fraudulent bills she submitted to Medicaid, U.S. Attorney Barry Grissom and Kansas Attorney General Derek Schmidt announced.

Doris Betts, 55, was sentenced in U.S. District Court in Kansas City, Kan., by Judge Eric F. Melgren to 18 months in federal prison, three years supervised release, restitution to the Kansas Medicaid program in the amount of $251,573.32, and a forfeiture judgment in the same amount.  Betts was charged in April 2014 with six counts of health care fraud.

She pleaded guilty in U.S. District Court and was convicted in November in a joint enforcement effort between the U.S. Department of Health and Human Services/Office of Inspector General and Kansas Attorney General’s Office.

The investigation revealed that between January 2008 and December 2013, Betts falsely billed for providing in-home services to two or more clients at the same time in different locations, while the client was hospitalized, and while Betts was instead at her own medical appointments.

During this period, Betts billed for more than 750 work days that exceeded 24 hours, the highest of which topped out at 39.5 hours.

Betts billed for a variety of services, including personal care services, sleep cycle support, day support and residential support. By using multiple billing agencies, Betts was able to bill for services that overlapped.

Nationwide, the personal care attendant program has been the number-one source of fraud complaints to state Medicaid fraud units.

“The personal care attendant program provides important in-home services for Medicaid recipients who need assistance to remain in their homes,” Schmidt said. “When the program is abused and taxpayers are defrauded, vital resources are taken away from vulnerable Kansans who are truly in need. We will continue to work cooperatively with our federal partners to protect this joint federal-state program and remain focused on finding and prosecuting those who defraud taxpayers through false billing.”

“Theft from our nation’s health care system hurts all of us,” U.S. Attorney Barry Grissom said. “We are using every tool at our disposal to fight health care fraud.”

The case was investigated by the attorney general’s Medicaid Fraud Division. Assistant Attorney General Stefani Hepford of Schmidt’s office and Assistant U.S. Attorney Tanya Treadway prosecuted the case.