FLORIDA—The owner of a Florida home health services agency and a parent of a disabled child have been arrested for alleged Medicaid provider fraud.
Attorney General Ashley Moody’s Medicaid Fraud Control Unit (MFCU) announced the arrests on Wednesday.
According to the MFCU, Latrena Marie Thomas owns A River’s Journey, a home health care agency with residential home care facilities located in Yulee and Jacksonville. Ms Thomas is accused of hiring non-licensed individuals to provide hands-on personal care services to Medicaid recipients.
In addition, the MFCU alleges that Thomas paid Donald Ray Adams II, a parent of a disabled Medicaid recipient, to provide medically licensed care for his own child.
In total, Ms Thomas is accused of fraudulently billing Medicaid claims for 30 distinct medically needy Medicaid recipients, which caused a total loss of more than $1.6 million.
“This fraudulent billing scheme not only defrauded the Florida Medicaid program out of more than $1.6 million but did so at the expense of Medicaid-dependent recipients, one being a disabled child,” said Ms Moody.
“In addition to manipulating the system for extra money, the hiring of unqualified and unlicensed medical staff resulted in poor treatment and medical emergencies for Medicaid patients. I’m grateful for our Medicaid Fraud Control Unit for putting a stop to this scheme.”
According to the investigation, Ms Thomas and the agency hired employees not licensed as certified nursing assistants or home-health aides to provide hands-on personal care to Medicaid recipients. Reportedly, several of these unqualified employees would have failed the Level 2 background screening required by the Florida Agency for Health Care Administration.
Thomas reportedly did not have a nursing director on staff to oversee the licensed practical nurses and other staff employed by A River’s Journey. Ms Thomas is also alleged to have falsified the agency’s employee roster, progress notes, service logs, and plan-of-care documents and billed for a recipient’s 24/7 nursing care while paying Mr Adams.
According to the MFCU, Thomas’s negligent assignment of unqualified staff to recipients created three separate medical emergencies, including a trach tube dislodging, extreme sunburn, and a delay in contacting Emergency Medical Services.
A River’s Journey reportedly paid Mr Adams for providing unsigned progress notes for his child’s care. The agency allegedly paid him in cash, gift cards, and bank deposits.
The investigation reportedly revealed that Mr Adams received $7,320 for involvement in the scheme to defraud Medicaid.
Thomas faces one count of Medicaid provider fraud, $50,000 or more—a first-degree felony. Adams faces one count of Medicaid provider fraud, $10,000 or less—a third-degree felony.
The Jacksonville Sheriff’s Office arrested Ms Thomas and the Clay County Sheriff’s Office arrested Mr Adams. Attorney General Moody’s MFCU will prosecute the case through the State Attorney’s Office for the Fourth Judicial Circuit.
