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Some Home Health Providers Not Following Federal Law

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With Medicaid one of the largest chunks of state budget spending, it’s no surprise some are honed in on curbing: “Fraud, waste, abuse in our Medicaid program.”

Representative Tony Bacala of Prairieville is one state lawmaker who has voiced consistent concerns. This spring, he shepherded a bill through the Legislature that set up a task force to examine Medicaid waste, fraud and abuse. The group convenes this fall.

Louisiana Attorney General Jeff Landry has created a Medicaid Fraud unit within his office, and Legislative Auditor Daryl Purpera has a group working on it, as well.

We began, I guess, about a year ago, developing a Medicaid Audit unit – maybe better described today as a data analytics unit,” Purpera told the Legislative Audit Advisory Council last week

While the A.G.'s unit looks toward punishment, the legislative auditor’s group aims at prevention. They recently uncovered a problem with some home and community-based Medicaid services: bogus social security numbers listed for health care workers. Approximately 1450 of the 40,000 current patient care workers had erroneous social security numbers listed.

How may of these are due to simple mistakes – typos – and how many are intentional?” state Senator Jay Luneau asked.

It's hard to say,” replied performance audit director Karen LeBlanc.

Representative Julie Stokes had questions for Department of Health Undersecretary Jeff Reynolds.

Those employees that we’re talking about, those workers are directly employed by LDH?” she inquired.

No,” Reynolds responded. “The provider has a contract with DHH to be a Medicaid provider, then those guys hire the direct care workers.”

Why isn’t there a requirement for them to collect, like, the proper paperwork to employ these people? I mean, because there’s federal guidelines,” Stokes wondered.

Federal law requires every employer to complete an I-9 form, verifying identity and social security numbers.

Reynolds says, in light of that law, “Whatever the provider gave us, we were assuming is valid. You know, we’re assuming they’re complying with the federal employment laws and have validated social security. Obviously, they’re not.”

The Health Department keeps a list of those banned from Medicaid due to fraud or due to instances of patient abuse. Incorrect social security numbers on record for patient care workers could then endanger unsuspecting patients.

Senator Mike Walsworth, chairman of the Legislative Audit Advisory, says ultimately it falls on the provider-employer to get it right.

At the end of the day, they’re going to give us a social security number for the worker. If it’s not correct, you don’t get paid.”