A former home health company owner accused of defrauding Medicaid and the Internal Revenue Service out of more than $2 million was sentenced Thursday to three years in prison.
As owner and operator of Home Health Care of Southeast Ohio, Cheryl McGrath, 50, of Guysville, OH, was responsible for billing, bookkeeping and employee payroll and taxes.
Prosecutors said Thursday she was also responsible for overbilling for services never provided, for services provided to ineligible Medicaid recipients — including some living in nursing homes — and for excess hours of care. Other supposed recipients were dead.
The conviction stems from McGrath’s actions between 2009 until 2015, according to a press release issued by the U.S. Attorney General’s Office in Columbus, OH, outlining the scheme.
“The defendant routinely changed the claim information in the billing software to falsely reflect that additional hours of nursing services had been provided and falsely increased the number of nursing visits from one visit per week to between three and five visits per week,” officials said.
Home health care has long been rife with fraud, and the Department of Health and Human Services’ Office of Inspector General has been ardent about reducing financial and other kinds of abuse in-home.
A Congressional bill with bipartisan backing would allow existing state Medicaid Fraud Control Units to address patient mistreatment outside of institutional settings for the first time. Protecting against waste and fraud, especially systematic efforts like McGrath’s, is becoming increasingly important. Medicaid spending on personal care services rose 21% between 2012 and 2015, according to the OIG.
In total, McGrath’s scheme included fraudulent claims in the amount of approximately $2.2 million. But her crimes didn’t stop there.