“Identifying Medicaid fraud and taking legal action to prevent it are two integral duties of my Office’s Medicaid Fraud Control Unit,” said Attorney General Schmitt. “Gaming the Medicaid system for personal gain is against the law and preys on our state's most vulnerable, and my Office will not hesitate to take action. In this case, my Office recovered over $300,000 in restitution and penalties, a great result for MO HealthNet and Missouri.”   The Attorney General’s Medicaid Fraud Control Unit (MFCU) discovered Healthy Home overbilled MO HealthNet for services that were to be provided in Medicaid recipients’ homes. The MFCU also found that Healthy Home attempted to cover up their fraudulent scheme by purposely altering records.   In the settlement agreement, Healthy Home, located in Farmington, Missouri, admitted that between October 9, 2018 and June 14, 2019, they submitted false claims to MO HealthNet seeking payment for more hours than their attendants actually provided care to recipients and that they later altered attendants’ timesheets to conceal the fraud.   In addition to the restitution and penalties, Healthy Home agreed to enhanced monitoring and oversight. The Medicaid provider is required to submit a corrective action plan to the Missouri Department of Social Services’ Medicaid Audit and Compliance Unit and be subject to a close-ended one year provider enrollment agreement.   This case was prosecuted by Assistant Attorneys General Travis Turner and Sarah Schappe and investigated by MFCU Investigator Taylor Walls.   The Missouri MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $2,818,808 for federal fiscal year 2021. The remaining 25 percent, totaling $939,601 is funded by the State of Missouri.  

###