Home Family Care, Inc. Billed Medicaid for Services of Unqualified Care Providers and Aides on Vacation When They Were Supposed to be Caring for Elderly Medicaid Recipients – Then Falsified Records to Cover Up the Neglect
Supervisor Responsible for Neglect to Pay $100,000 in Separate Settlement
BROOKLYN – Attorney General Eric T. Schneiderman today announced that Home Family Care, Inc. (“Home Family”) of Brooklyn, NY and its President, Alexander Kiselev, will pay $6.415 million to resolve allegations that they violated the federal and New York False Claims Acts by falsely billing the New York State Medicaid program for home health care services that were not provided or that were provided by unqualified staff.
The settlement resolves allegations in a complaint filed by the State of New York and the United States that Home Family routinely permitted its aides to circumvent verification procedures purportedly put in place by Home Family to ensure that its aides were providing scheduled services to Medicaid recipients who depended upon them. As alleged in the complaint, even after Home Family put in place an electronic attendance verification system which purportedly required aides to call a central number to “clock in” and “clock out” of their shifts before their services could be billed, Home Family aides routinely ignored this requirement and failed to clock in or out of their shifts – yet were still paid for them.
“New Yorkers place the highest level of trust in home care providers to care for their vulnerable family members,” said Attorney General Schneiderman. “My office will continue to make clear that there are serious consequences for neglecting vulnerable home care patients – and even further consequences for trying to cover it up before sending New Yorkers the bill.”
Medicaid is a jointly funded federal-state program that provides health care to vulnerable individuals. Home Family operates a Licensed Home Care Services Agency (“LHCSA”), which provides home health aide and personal care aide services to frail and elderly individuals, including Medicaid recipients, who need assistance with activities such as cooking, cleaning, dressing, and bathing. Home Family bills these services to Managed Long Term Care (“MLTC”) Plans and Certified Home Health Agencies (“CHHA”), which in turn bill the New York State Medicaid Program for these services. As a LHCSA, Home Family was obligated to ensure that the home health care services – which its clients depended upon to remain in their homes – were provided by qualified staff, and to maintain records documenting the services that were rendered.
The Attorney General’s complaint alleges that the aides’ supervisors, known as Coordinators, in turn, modified or created call entries in the attendance verification system to make the records appear as if the aides had clocked in or out of their shifts. The complaint also alleges that Home Family then billed for these services, without even attempting to contact the aides or otherwise verify that the aides had visited their clients. As further alleged in the complaint, Michael Gurevich, a former Vice President of Home Family who had responsibility for supervising the Coordinators, was aware of the efforts of Home Family aides and Coordinators to circumvent Home Family’s attendance verification systems and took no measures to stop it. In a separate agreement, Mr. Gurevich has agreed to pay $100,000 to resolve the allegations against him.
The complaint further alleges that, as a result of Home Family’s circumvention of its own attendance verification systems and procedures, Home Family on multiple occasions billed for services of aides who were traveling outside of the country during times when they were supposed to be caring for their clients. In one instance, Home Family billed for the services of an aide who was vacationing on the island of St. Maarten on the dates when Home Family claimed he was providing these services.
In addition, as alleged in the complaint, Home Family employed numerous individuals who were not qualified to provide home health care services, and who utilized false identifies stolen from qualified individuals in order to obtain employment. Furthermore, even after Alexander Kiselev became aware that unqualified individuals were obtaining employment at Home Family using false identities, the complaint alleges that neither Mr. Kiselev nor anyone else at Home Family took any meaningful steps to ensure that Home Family’s clients were being properly cared for by qualified aides.
The investigation was triggered by a whistleblower lawsuit filed under the qui tam provisions of the federal and New York False Claims Acts, which allow private persons, known as “relators,” to file civil actions on behalf of the government and share in any recovery. The case is docketed with the U.S. District Court for the Eastern District of New York under number 10-CV-2490. The investigation and settlement were the result of a coordinated effort among the U.S. Attorney’s Office for the Eastern District of New York, the New York State Attorney General’s Office, and HHS-OIG. The United States was represented by Assistant U.S. Attorney Elliot Schachner.
The state case was handled by Special Assistant Attorneys General Andrew Gropper and Jill D. Brenner, and Senior Auditor Investigator Olga Sunitsky, with the assistance of Carolyn T. Ellis, Chief of the Civil Enforcement Division of the Medicaid Fraud Control Unit. Additional investigative support was provided by Senior Investigator Albert Maiorano and Investigator Alexander Kats, with the assistance of Deputy Chief Investigator-Downstate Kenneth Morgan. The Medicaid Fraud Control Unit is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney. The Division of Criminal Justice is led by Executive Deputy Attorney General Margaret Garnett.