The Health Services of Northern New York, Inc., a home health care provider based in Potsdam, New York, agreed in December 2013 to pay back $455,000 in overpayments it received from the Medicaid program from January 1, 2005 to December 31, 2012, a period of seven years. In a settlement reached with the New York State Attorney General’s Office, the company agreed to repay Medicaid $431,983.43, plus interest, for an amount totaling $455,000. During an audit performed by the Attorney General’s Medicaid Fraud Control Unit (MFCU), investigators discovered that Health Services submitted cost reports that were incorrectly filled out from 2003 to 2012. The information from the incorrect cost reports was used by Medicaid to determine how much money the company would receive from the agency for providing services to patients. Because the cost reports were incorrect, MFCU auditors and investigators determined that the company received substantial overpayments for services provided and billed to Medicaid.
According to the settlement, Health Services admitted to submitting the incorrectly completed cost reports from 2003 to 2010 for personal care aide services and certified home health agency services. As a result, the company admitted that it was overpaid by Medicaid for providing such services. MFCU auditors and investigators revealed that the health care company received overpayments in several areas. For instance, from 2003 to 2006, Medicaid overpaid the company for personal care aide services and certified home health agency services management fees. In addition, from 2007 to 2010, Health Services received Medicaid overpayments for personal care aid services allocated management fees. Moreover, the company received too much money from the Medicaid program for certified home health agency services bad debt expenses from 2004 to 2006. Finally, auditors and investigators uncovered that Health Services received overpayments for certified home health agency services transportation mileage costs for 2003 to 2006.
Commenting on his office’s financial settlement with the home health provider, Attorney General Eric T. Schneiderman stated that he was pleased that the agreement resulted in a positive outcome for the taxpayers. He remarked, “Whether intentional or not, I’m pleased that this ongoing issue was recognized and remedied on behalf of New York’s most vulnerable populations. My office remains vigilant in our fight to ensure that Medicaid dollars end up in the right hands, and with the cooperation of Health Services of New York, this money will be paid back and directed to its intended purpose–to better the lives of New York’s Medicaid beneficiaries.”
AG announces settlement with Health Services of Northern New York, Inc., Daily Courier-Observer, December 13, 2013