A Plymouth couple are accused of false billings in cases involving vulnerable low-income patients.
Advantage Home Care Services of St. Paul was supposed to help some of the community's most vulnerable low-income residents -- those who need home health care due to injury, disease, mental illness or other disability.
But the couple who ran it weren't providing all the hours they were billing Minnesota medical assistance for, so those clients weren't getting all the care claimed -- nor were they served by registered nurses, though the company was billing the state's program for that, according to complaints filed Wednesday in Ramsey County District Court.
Charged with two counts of medical assistance fraud and one count of theft by false representation were Blessing U. Anyanwu, 49, and her husband, Ernest Anyanwu, 54, of Plymouth.
She allegedly helped him submit claims for reimbursement for personal-care-attendant and registered-nurse services while intentionally lying about the services provided.
She's a registered nurse who received $1.2 million from Advantage from 2006 through July 2010.
Payments not reported
The couple claimed Ernest Anyanwu didn't get any pay as administrator and manager, but bank records show he received more than $70,000.
They've been involved in home health care services since 1994, previously operating the business as Sholom Holistic Care and Home Advantage Health Services.
They sold the business in February 2006 to another man but continued to run day-to-day operations while the man drove a cab.
In 2008, when the alleged fraud came to light, the company, operating at 780 W. University Av. in St. Paul, received more than $1.7 million in paid claims for 213 recipients.
During the probe from September 2008 through March 2009, the Minnesota Department of Human Services (DHS) reimbursed Advantage nearly $5 million.
Phony names, services
The Medicaid program provides medical care and services to low-income Minnesotans through DHS, which contracts with or enrolls health care providers to serve recipients.
The providers submit claims to DHS to be reimbursed.
Claims allegedly were falsified with phony names, falsified timesheets and billing for registered-nurse services when licensed practical nurses showed up.
The investigation began with Maple Grove police investigating a report in which a man was to receive 10 hours of daily service from a personal-care attendant, but the phony claim submitted by Advantage was for 14 hours.
A case manager for the man reported the discrepancy and also contacted Hennepin County Adult Protection and DHS, touching off the probe.
Joy Powell • 651-925-5038