Medicaid fraud unit action results in 15 assisted living convictions

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Medicaid fraud unit action results in 15 assisted living convictions
Medicaid fraud unit action results in 15 assisted living convictions

Assisted living facilities were involved in 14 criminal convictions for abuse or neglect based on the actions of State Medicaid Fraud Control Units in fiscal year 2015, according to the recently published annual report from the Department of Health and Human Services Office of Inspector General. Recoveries totaled $125,813.

Additionally, unit activities resulted in one criminal conviction for fraud involving an assisted living facility, with $1,465 recovered.

The annual report also includes data for other types of facilities and providers; specific positions, such as nurse and nurse aide; and state-related data.

In FY 2015, according to the report, State Medicaid Fraud Control Units reported a total of 1,553 criminal convictions across all types of facilities, positions and programs, and almost one-third of the convictions involved personal care services attendants. Fraud cases accounted for 71% of the 1,553 convictions. Units reported almost $350 million in criminal case recoveries.

The number of convictions was the highest reported in the past five years, the OIG said. The report highlighted one abuse conviction involving an assisted living nurse who was caught by a hidden camera assaulting a resident who resisted attempts to be dressed. The nurse was sentenced to two years of probation and was barred from being employed by any federally funded healthcare program.

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