Credit: Eric Rothermel / Unsplash.com
The Pennsylvania Attorney General's Office said the overlapping care times were 'impossible,' said reports.
One direct care worker (DCW) with a Horsham-based business falsified records, claiming to care for four different medical assistance recipients at over-lapping times, according to reports.
Lynette R. Weathers, 37, of the 4700 block of Valley Place in Philadelphia, faces multiple felony charges after the Pennsylvania Office of the Attorney General investigated submitted timesheets for the in-home medical aid provider who worked for Help at Home, a business located at 400 Horsham Road, Suite 130, in Horsham. The agency alerted authorities to suspicious records after providing services for a local resident.
As part of the Pennsylvania Department of Human Services’ Community Health Choice Waiver, a local person was receiving in-home assistance through Help at Home. The employees of this service are to keep records and submit timesheets through the agency, and then that agency reaches out to the Managed Care Organization (MCO), sending payment based on those records.
An agent of Help at Home provided the Pennsylvania Attorney General’s Office (PAGO) with submitted timesheets Weathers had provided for the care of her single individual with their agency, said reports. However, investigations by the PAGO uncovered multiple agencies that Weathers claimed to be working for at the same time, including All American Homecare, Daily Dove Care, and B&S Homecare LLC, in addition to Help at Home. Special Agents through the Pennsylvania Bureau of Criminal Investigations, Medicaid Fraud Control Section, said that, according to the records they compared denoting Weathers’ working hours, it was impossible for all of the counted times to be serviced by the same worker.
Weathers claimed, reports stated, that she was caring for at least four unique individuals on the Medicare DCW program. However, investigators stated that “Weathers could not have provided” various hours on her timesheets.
As some agencies and clients were in Philadelphia, Montgomery, and Delaware counties, the distance between the home addresses and overlapping reported times made it impossible to occur simultaneously, meaning documents were falsified, reports said.
Spanning a time between February 2022 and March of 2023, the PAGO said Weather’s total fraudulent time submissions “caused several providers to be paid for at least 570.5 hours of DCW services that could not have been provided.” After payroll records were reviewed, the PAGO estimated that, as all agencies were in-turn paying Weathers, the fraudulent submissions “caused [Medical Assistance] to pay out at least $12,234.12 for services that were not rendered.”
According to the criminal complaint, Weathers is charged with Medicaid Fraud, submission of false information; two counts of Medicaid Fraud, services not rendered; Medicaid Fraud, misrepresentation, theft by deception, tampering with public records, and criminal use of a communication facility, all of which are felony-grade charges.
Weathers was released on a bond signature for an unsecured $7,500 bail and is due in court on Nov. 14 at 11:30 a.m. before Magisterial District Judge Todd Stephens to face her charges.
All suspects and defendants are innocent until proven guilty. This story was compiled using public court records.
