A years-long investigation into a home health care provider in Highland, Indiana, has resulted in a $217,000 settlement and criminal conviction obtained through the hard work of Indiana Attorney General Todd Rokita’s Medicaid Fraud Control Unit (MFCU).
Following a tip, MFCU investigators discovered that Allpoints Home Health Care Inc. billed the Medicaid program for thousands of hours not actually worked. In all, the business was found to have submitted 1,055 false claims.
“Week after week, our nationally renowned Medicaid Fraud Control Unit does outstanding and incredibly thorough work on behalf of Hoosiers,” Attorney General Rokita said. “And of all the types of fraud committed, what is more sinister than stealing money which was intended to help low-income sick people pay their health care bills?”
In some instances, the perpetrators were particularly sloppy in their falsification of records — such as claiming to provide home health care to one patient during a time when that individual was hospitalized and not even at home to receive the purported home services.
As part of the investigation, MFCU staff analyzed claims submitted to Medicaid, interviewed Allpoints employees, reviewed medical records and perused Electronic Visit Verification sheets.
By the time all the facts were gathered, investigators had enough evidence not only to pursue a settlement but also to work with the Lake County Prosecutor’s Office to achieve a criminal conviction as well.
Mohammad Adnan Satti — the employee who prepared and submitted the majority of the false claims — was convicted for felony theft and sentenced to 18 months suspended jail time as part of a plea agreement.
Allpoints agreed to pay Indiana $217,019.61 in exchange for escaping civil liability for violations of the Indiana Medicaid False Claims and Whistleblower Protection Act. That’s three times the overpayments identified by our team’s analysis of the claims data.
Attorney General Rokita thanked MFCU Director Matt Whitmire, Deputy Attorney General JeremyJohnson and former Deputy Attorney General Jordan Stover for their work on this case.
The Indiana Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a federal grant. The remaining 25 percent is funded by the State of Indiana.