Missouri – A Missouri home health care provider has agreed to pay more than half a million dollars to settle claims of illegal Medicaid billing. This is a big federal and state enforcement action focused on holding patient service providers accountable. According to prosecutors, Deer Valley Home Health Services LLC, a firm based in St. Louis, filed claims for work done by someone who wasn’t qualified to do the services they claimed for. The claims that were disputed were made between October 1, 2022, and May 31, 2023.
Federal officials say that the claims in question were for applied behavior analysis services, which included evaluations and treatment plans for people with behavioral or developmental difficulties. Investigators said that the worker who made those applications lied about his qualifications and reported service hours that were not realistic—more than a full day’s worth in a single 24-hour period. Officials say that he started out as a contractor and then became an employee of the company, but he wasn’t properly certified or qualified to bill Medicaid for the services he said he had delivered.
In May 2023, the person left Deer Valley Home Health Services. In July, two months later, the employer revealed concerns about his behavior, which led to a more thorough review. Federal investigators say that the company worked with them the whole time and that they didn’t know about the fake invoices before. Still, the settlement requires Deer Valley to repay $534,475 to resolve the allegations.
The U.S. Attorney’s Office, the U.S. Department of Health and Human Services Office of Inspector General, and Missouri’s Medicaid Fraud Control Unit investigated the case. Assistant U.S. Attorney Suzanne Moore oversaw legal action on behalf of the government.
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Officials say the result strengthens efforts to protect the integrity of Medicaid and make sure that only qualified providers give proper care. Linda T. Hanley, Special Agent in Charge of HHS-OIG, said that false billing hurts the confidence of taxpayers and makes it harder for patients to get care. She stated that the settlement shows how they are still working with law enforcement to protect public program funding and make sure that vulnerable people get the care they need.
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The case’s outcome ends an investigation that has been going on for months, but it will probably still be a point of reference in future oversight proceedings involving home health providers.
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As part of a larger effort to stop unqualified service delivery and false claims in taxpayer-funded health care systems, investigators said that monitoring, enforcement, and recovery activities will continue.
