Family First Home Health Care, Inc., a home healthcare agency located in Gastonia, NC (now d/b/a Gaston Piedmont Health Care Inc.), and its owner Marion James have agreed to collectively pay $600,000 to resolve allegations that they knowingly violated the federal and North Carolina False Claims Acts from January 1, 2015, through January 9, 2020, by submitting thousands of fraudulent claims to Medicaid for reimbursement. Specifically, the United States and State of North Carolina (together, the Governments) alleged that Family First and James billed Medicaid for personal care services that were never performed, such as billing for in-home services on days when patients were hospitalized. Similarly, the Governments alleged that Family First and James billed for years of personal care services purportedly provided to patients in their homes by James’ daughter while she was hours away at college as a full-time student playing on the varsity basketball team, or billed for services provided by an aide after that aide had moved out of state.
The Governments further alleged that Family First and James engaged in a scheme to have family member aides provide personal care services to their own family member beneficiaries (for example, a daughter providing services to her mother) in violation of state Medicaid regulations, and then fraudulently bill for those services as if they were performed by a non-related aide, forging documents and signatures to perpetuate the scheme.
