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ResCare whistleblowers - Have Evidence of Res -Care Misconduct? 12/76/18, 11:37 AM Iowa Res Care Medicaid Fraud 'n 2015, Res -Care and ResCare Iowa paid $5.63 million to settle Medicaid fraud charges brought Icy the Justice Department and Iowa. Prosecutors say that physicians were not completing the annual assessments needed for patients receiving homecare. According to the Justice Department,'The rules of both Medicare and the state of Iowa's Medicaid program require an independent physician to certify that home healthcare services are medically necessary and to order the specific type and amount of healthcare services to be provided by the home health agency. Additionally, since 2011, Medicare and Iowa Medicaid rules require these independent physicians to perform an in-person "face-to-face" assessment of each patient before the home health agency can bill the government for any home healthcare services. The settlement resolves allegations that between 2009 and 2014, ResCare Iowa billed the government for services provided to Medicare and Medicaid patients in Iowa without documenting compliance with these requirements' Res Care and West Virginia (Neglect, Sexual Abuse) Allegations West Virginia authorities are reportedly investigating the company after a patient recently died while in ResCare's care. Media reports say the facility where the death occurred has received "dozens" of complaints including claims of neglect, sexual abuse and training deficiencies. eroviding improper or grossly deficient care can be a violation of Medicaid rules. When we entrust a loved one to the care of a professional healthcare company, we assume that they will be protected, receive adequate care and be safe. Improper staffing, patient abuse or improper training can all be violations of Medicaid guidelines. Indiana Medicaid Fraud We are also aware of yet another Medicaid fraud case currently making its way through the courts in Indiana. A former ResCare Qualified Intellectual Disabilities Professional (QIDP) filed suit in 2015 claiming that a manager told her that the company did not have enough staff to provide required services needed by patient. She claims that the manager "advised the QIDPs to begin recording their time spent on preparing developmental and behavioral plans as direct care hours [and] directed the QIDPs to backdatethis time to reflect direct care in their progress notes forthe month of February." Medicaid regulations do not allow these services to be billed as direct care. Her Medicaid fraud case was tossed on technical grounds earlier this year although the judge said she could refile her claim. https://www.tuIly-weiss.com/blog.php?article=rescare-whistleblowers-have-evidence-of-res-care-misconduct-76 Page 5 of 11