Hungry for Fraud

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As senior citizens age, it becomes harder to prepare nutritious meals, especially if living on a limited budget. Fortunately, Medicaid provides home-delivered meals to qualified beneficiaries. An article posted on MagicValley.com details the story of an Idaho-based, Medicaid-certified home-delivery meal provider that is in a bit of hot water over allegations that the company bilked the government program out of nearly $900,000.

The frozen-meal delivery company is being slapped with a lawsuit that claims the service knowingly submitted or caused to be submitted false and fraudulent claims through the Idaho Medicaid system. The lawsuit states that the company was submitting claims that were not in compliance with the Medicaid provider agreement. Further research revealed that the delivery service may have been billing for desserts. (Medicaid doesn’t pay for you to have your cake and eat it too.) In addition, they were supposedly billing for meals delivered to an excluded place of service, such as an assisted living facility. Also, the lawsuit claims that Medicaid was receiving bills for unauthorized meals. Lastly, meals were purportedly delivered to deceased recipients or to those who were hospitalized. (Now that leaves a bad taste in your mouth, doesn’t it?)

Remember that the meal-delivery company is presumed innocent and deserves its day in court. However, being accused of violating the False Claims Acts, which makes people and companies liable for defrauding government programs, is serious business. The company could incur damages as high as $2.6 million if found guilty.

This case will serve as a warning to similar people or companies who have eyes that are bigger than their stomachs. The government doesn’t put up with selfish greed against a government program meant to provide meals for eligible beneficiaries. The type of fraud alleged is not only is a disservice to taxpayers, but also to those deserving citizens who have paid into the program and deserve to reap the benefits of their labor.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Federal Trial Set in Frozen Meals Medicaid Fraud Case,” written by Alison Gene Smith and published by MagicValley.com on July 17, 2014.

KIMBERLY – A Kimberly frozen-meal delivery company accused of bilking Medicaid out of nearly $900,000 has a federal trial set for 2015.

Prosecutors say Homestyle Direct illegally billed Medicaid $888,152, delivered meals to deceased clients, lied to clients about Medicaid requirements and continued to deliver meals to Medicaid clients’ homes even when they were hospitalized.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.