CHARLESTON — The West Virginia Department of Health and Human Resources is suing Elder Aide Services for alleged Medicaid fraud.
The DHHR claims the defendant willfully made, attempted to make and/or caused to be made certain claims for benefits, payments, or allowances under the medical programs of the DHHR in connection with the operation of their facility, under such circumstances that the defendant knew or should have known the claims were false, fictitious or fraudulent, according to a complaint filed in Kanawha Circuit Court.
Between Sept. 6, 2019, and Dec. 22, 2021, the defendant submitted claims for payments to West Virginia's Medicaid program which constituted fraudulent billings due to the fact more homemaker services units were claimed and paid than were documents on time sheets and/or sufficient documentation was not maintained to support the claims, according to the suit.
The DHHR claims the inappropriate billings for services resulted in overpayments to the defendant totaling $151,907.79.
As a direct and proximate result of the defendant's wrongful acts and omissions, the DHHR suffered damages in the amount of $151,907.79 and wants to recover treble damages in the amount of $455,723.37, according to the suit.
Elder Aide Services does business as Right At Home. The company does personal care services, companion services, nursing services and specialty care for older adults.
The DHHR is seeking damages in the amount of $455,723.37 with attorneys' fees and investigative fees. It is represented by Assistant Attorney General Michael Myers of the Medicaid Fraud Control Unit of the West Virginia Attorney General's Office in Charleston.
The case is assigned to Circuit Judge Kenneth Ballard.
Kanawha Circuit Court case number: 23-C-522