Gastonia home health care company reach settlement for five-year Medicaid fraud allegations

CHARLOTTE, N.C. (QUEEN CITY NEWS) — A Gastonia home health care business has reached a settlement following several allegations of Medicaid fraud, according to the U.S. Attorney’s Office.

Family First Home Health Care Inc. — now known as Gaston Piedmont Health Care Inc. — and its owner Marion James were accused of knowingly violating the Federal and North Carolina False Claims Acts from Jan. 1, 2015, through Jan. 9, 2020, by allegedly submitting thousands of fraudulent claims to Medicaid for reimbursement, announced Dena J. King, U.S. Attorney for the Western District of North Carolina. Family First and its owner agreed to collectively pay $600,000.

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United States and N.C. officials 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. Further, Family First and James allegedly billed for years of personal care services purportedly provided to patients in their homes by James’ daughter while she was instead attending college as a full-time student.

“Medicaid beneficiaries qualifying for personal care services are those that require assistance with daily living tasks, often the elderly,” said King. “This settlement demonstrates that those who would profit from defrauding government healthcare payors while taking advantage of vulnerable patients entrusted to their care will be held accountable.”

The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by former Family First employee Heather Coleman. The settlement amount was based on Family First and James’ ability to pay.

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“Submitting false claims to Medicaid undermines the integrity of the program and wastes valuable taxpayer dollars,” said Special Agent in Charge Tamala E. Miles at the Department of Health and Human Services, Office of Inspector General (HHS-OIG). “Working closely with our law enforcement partners, HHS-OIG remains committed to investigating providers who allegedly defraud federal health care programs.”

Assistant U.S. Attorney Seth Johnson and Investigator Cathleen Hollowell of the U.S. Attorney’s Office in Charlotte investigated the matter, in conjunction with the N.C. Attorney General’s Office and U.S. Department of Health and Human Services.

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