INDIANAPOLIS – A years-long investigation into a home health care provider in Highland, Indiana, has resulted in a $217,000 settlement and criminal conviction obtained through the hard work of Attorney General Todd Rokita’s Medicaid Fraud Control Unit (MFCU).
Following a tip, MFCU investigators discovered that Allpoints Home Health Care Inc. billed the Medicaid program for thousands of hours not worked. In all, the business submitted 1,055 false claims.
“Week after week, our nationally renowned Medicaid Fraud Control Unit does outstanding and incredibly thorough work on behalf of Hoosiers,” Attorney General Rokita said. “And of all the types of fraud committed, what is more sinister than stealing money intended to help low-income sick people pay their health care bills?”
In some instances, the perpetrators were particularly sloppy in their falsification of records—for example, they claimed to provide home health care to one patient while that individual was hospitalized and not even at home to receive the purported home services.
As part of the investigation, MFCU staff analyzed claims submitted to Medicaid, interviewed Allpoints employees, reviewed medical records, and perused Electronic Visit Verification sheets.
By the time all the facts were gathered, investigators had enough evidence to pursue a settlement and work with the Lake County Prosecutor’s Office to achieve a criminal conviction.
Mohammad Adnan Satti, the employee who prepared and submitted the majority of the false claims, was convicted of felony theft and sentenced to 18 months suspended jail time as part of a plea agreement.
Allpoints agreed to pay Indiana $217,019.61 to escape civil liability for Indiana Medicaid False Claims and Whistleblower Protection Act violations. That’s three times the overpayments identified by our team’s analysis of the claims data.
Attorney General Rokita thanked MFCU Director Matt Whitmire, Deputy Attorney General Jeremy Johnson, and former Deputy Attorney General Jordan Stover for their work on this case.
The Indiana Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a federal grant. The State of Indiana funds the remaining 25 percent.
The settlement agreement is attached.
