The state is yanking the license of a home health care agency after FOX 4 raises questions about unlicensed nursing and Medicare abuses.

T and T Home Health billed Medicare millions of dollars over the past two years but FOX 4 questioned whether the agency was really helping the elderly or just helping itself. Our 4-month investigation prompted the Texas Department of Aging and Disability Services (DADS) to step in. DADS licenses health care businesses that receive federal Medicare dollars.

DADS spokesperson Laura Albrecht says the state found far too many deficiencies including unlicensed workers, poor record keeping, and missed patient visits.

Last fall 79-year old Ann Love told FOX 4 that T and T signed her up for home health care services, but all the worker did was vacuum. Love isn’t homebound, a basic requirement for federal home health care coverage. Love’s Medicare statement showed T and T billed for seven skilled nursing visits in 2008 at $125 per visit.

Rosemary Salm also signed up with T and T. She says the woman making the home visits didn’t wear a badge but told her she was a nurse.

DADS investigators interviewed both Love and Salm and found T and T was using unlicensed home health workers. The state report shows the administrator admitted one worker wasn’t an actual employee, saying the worker was a woman she met during a mission trip and sponsored here in the U.S. The report shows the woman was unlicensed as a doctor or nurse but was sent out to work with patients anyway.

The actions of this agency are bold and they are alarming,” says Albrecht. “We have an agency that was using – not even an employee to go in and provide skilled nursing care…to at least three clients that we found,” Albrecht told FOX 4.

Investigators also wrote up T and T for failing to provide patients with their plan of care. Ann Love asked for a copy of her plan of care and our undercover camera captured the response. “By law we are not supposed to release your file to you,” T and T Owner, Florence Urevbu told Love. But that’s not true. By law Urevbu was supposed to release the plan of care to Love.

The state also cited T and T for nurses failing to show up for patients visits. T and T blamed the problem on staffing shortages. “We got those documents. We are not buying in to that,” says Albrecht. “We cited them for deficiencies and not providing the care.”

Urevbu is appealing the decision and has requested a hearing. Neither Urevbu nor her attorney returned calls to FOX 4.

Meanwhile state senator Jane Nelson is pushing for criminal background checks and fingerprint identification for health care licensees and employees, including home care agency owners and employees as well as volunteers. “It’s a pot of gold sitting there,” Nelson told FOX 4. “There has been so little oversight and so little attention paid to ensuring people who are dishonest are not in the profession,” Nelson continued. Nelson filed Senate Bill 280 which has passed through the Senate and is expected to pass through the House. “Texas has been seen as a magnet for those who would like to take advantage of the system,” says Nelson.

Earlier this year the General Accounting Office reported fraud and abuse helped boost Medicare spending by 44% over a 5-year period. In that same time frame, spending on homebound patients in Texas increased 144%, the highest increase of any state in the U.S.

Last year FOX exposed a Nigerian national responsible for a chunk of that fraud. After our story aired the feds shut down Irene Anderson’s home health care businesses. She pleaded guilty to Medicare Fraud and was sentenced to 4 years in prison and ordered to pay more than two million dollars in restitution. A simple FBI fingerprint check would have shown Anderson was ordered deported 16 years ago.

The General Accounting Office is calling for tougher federal rules and background checks, too. “Those who come to Texas who are interested in scamming the system, we will find you and take action,” U.S. Congressman Michael Burgess told FOX 4. “We have to focus like a laser beam and this has to be fixed. We cannot afford to not deal with a problem of this magnitude and then talk about expanding the public side of the system. We are just asking for national bankruptcy if we do that,” Burgess continued.


To view the original article click here.