The Medicare fraud lawyers at MahanyLaw are investigating possible Medicare fraud by Always Best Care of Michiana. The company is also known as Always Best Care Senior Services.
According to the company’s website, Always Best Care has been in business since 1996. The company offers home care to patients throughout the Michiana area of Indiana and Michigan. The company claims it provides services to people living in Michiana , Mishawaka, South Bend, Granger, Elkhart, Nappanee and Cass, Berrien and St. Joseph Counties in southwest Michigan.
Always Best Care Fraud Allegations
According to the company’s website, “Our vision is to work as a united TEAM providing the best senior care in the world – with the broadest range of services, and the most loving and consistent care anywhere.” A patient reports, however, that the company bills for services not provided. If true, that constitutes Medicare fraud.
According to the Medicaid Fraud Hotline folks, billing for services not provided is a common Medicare and Medicaid scam. This would include billing for home visits that were never performed. Another variation is billing for more time in the home than was delivered. An example is a home healthcare worker who is in the home for 1 hour but later bills Medicare for 3 hours.
To be paid, patients must sign forms indicating that a nurse, therapist or aide was at their home and for what time period. Unscrupulous home healthcare agencies either forge the patient signatures or take advantage of patients who are mentally ill or quite sick.
Physicians are often in on the scheme as home healthcare needs to be medically approved.
Home health care schemes are one of the most prevalent forms of Medicare fraud in the nation. The Department of Health and Human Services believes that 1 in 20 home care agencies engages in fraud.
Five characteristics of fraud include high percentages of:
- episodes of care during which a beneficiary had no recent visits with the supervising doctors
- episodes of care not preceded by a hospital or nursing home stay
- episodes of care with a primary diagnosis of diabetes or hypertension
- beneficiaries with claims from multiple agencies
- beneficiaries with multiple home health readmission in a short time
Although the nationwide instances of fraud may only be 5% (we believe it is closer to 10%), certain areas have much higher instances of fraud. They include:
- Miami – Ft. Lauderdale (1st place)
- Detroit / Saginaw/ Flint / Dearborn / Pontiac (2nd place)
- Houston (3rd place)
- San Antonio
- New York City
- New Orleans
- Provo, Utah
Allegations are Not Proof of Fraud
There have been no charges against Always Best Care. We stress that we are investigating a claim by a patient. There are no allegations of poor care.
Earlier this year, Lehigh Valley Live reported a home healthcare employed by Always Best Care allegedly stole a credit card from a patient’s home. While serious, a single incident of theft by an employee doesn’t mean the company is guilty of any wrongdoing.
Seeking Always Best Care Whistleblower – Cash Awards
The federal False Claims Act pays whistleblowers cash awards for inside information about fraud involving federally funded healthcare programs including Medicare. Indiana and Michigan have their own False Claims Act that apply to state funded Medicaid.
Most Medicaid and Medicare fraud prosecutions begin with a tip from a concerned healthcare worker. We are looking to speak with a current or former employee of Always Best Senior Services with information about Medicare billing fraud.
Under the False Claims Act, whistleblowers are entitled to awards of up to 30% of whatever is collected from the wrongdoers. Because the law provides for triple damages and huge fines, the awards can quickly increase in size.
Awards are generally only paid to the first who files a lawsuit under the Act. Wait too long and you probably don’t qualify for an award.
Worried about retaliation? Federal and state law protect whistleblowers. If you suffer retaliation, your employer is responsible for double back pay, legal fees, reinstatement, future pay and other losses.
Although we are investigating Always Best Care, we have brought cases in over 35 states. Home healthcare fraud isn’t limited to any particular state or company. If you have information about homecare fraud anywhere in the United States or Puerto Rico, we are interested. We also prosecute all forms of healthcare; kickbacks, medically unnecessary services, durable medical equipment fraud, double billing, false documentation and pharmaceutical frauds.
Simply want to help in our investigation? We would love to hear from you. Looking to learn more? Visit our Homecare and Hospice Fraud page.