Iowa home health provider to pay $5.6 million to settle false claims allegations   

CEDAR RAPIDS - An Iowa home health care company accused of violating regulations regarding Medicare and Medicaid has agreed to pay $5.6 million, U.S. Attorney Kevin Techau of the Northern District announced Tuesday.

ResCare Iowa Inc. has agreed to the settlement to resolve allegations that it violated the False Claims Act by submitting false home health care billings to the Medicare and Medicaid programs. ResCare Iowa is a subsidiary of Louisville, Ky. based ResCare Inc.

'We commenced this investigation due to concerns that this provider was not complying with the rules and was not submitting accurate claims for payment,” Techau said in a news release. 'When the government pays for home-based medical services, we are dedicated to ensuring the money is well spent and medically deserving patients receive the care to which they are entitled.”

Medicaid is jointly funded by the states and the federal government. The state of Iowa, which paid part of the Medicaid funds at issue, will receive $2.3 million of the settlement.

Steve Young, spokesperson for U.S. Attorney's Office, said the Iowa portion will go to the state's Medicaid program.

This settlement was the result of a coordinated effort by the U.S. Department of Justice's Civil Division, Assistant U.S. Attorney Jacob Schunk for the Northern District of Iowa, HHS-OIG, and the Iowa Attorney General's Office.

The rules of both Medicare and Iowa's Medicaid program require an independent doctor to certify home health care services are medically necessary, and to order the specific type and amount of services to be provided by the home health agency.

In addition, since 2011 Medicare and Iowa Medicaid rules require these independent doctors to perform in-person 'face-to-face” assessment of each patient before the agency can bill the government for any home health services.

The settlement resolves allegations that between 2009 and 2014, ResCare Iowa billed the government for services provided to Medicare and Medicaid patients in Iowa without documenting compliance with these requirements.

The 'numerous deficiencies” were discovered during a March 2014 routine recertification survey by Iowa Department of Inspections and Appeals at the agency in Cedar Rapids, according to the settlement agreement. There are other stipulations in the settlement regarding procedures and requirements the agency must follow.