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BROOKLYN---Americare Certified Special Services, Inc. (Americare), a Brooklyn based certified home health agency, has agreed to pay $7 million as part of a resolution of a state investigation whether it had improperly billed Medicaid for services rendered to residents in adult homes. Home Health Agencies such as Americare provide health care to persons living in their own homes, and also in "adult homes" which are residential facilities that do not provide skilled nursing care.
The agreement follows an investigation by the Attorney General's Medicaid Fraud Control Unit ("MFCU") which found that Americare had been overpaid by Medicaid for services rendered from Jan. 1, 1997 through Dec. 31, 2004. Specifically, MFCU found that Americare improperly billed for excessive hours, hours not substantiated as medically necessary, and hours for services that the adult homes were expected to provide without charge to Medicaid.
Americare has ended the practices identified by MFCU and has further agreed to institute a compliance program and an employee code of conduct, including appointing a compliance officer responsible for internal compliance audits, compliance training, and advising Americare and its employees on compliance questions. Americare further agreed to institute and maintain an improved records management system. 11-21-05
© 2005 North
Country Gazette
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