Iowa agency to pay $1 million to settle Medicaid billing allegations
An Iowa agency that cares for children with disabilities has agreed to pay $1 million to settle federal authorities’ allegation that it overcharged Medicaid.
The agency, based in West Des Moines, was known as Ultimate Nursing Services when the disputed bills were filed from 2011 to 2013. It now uses the name of a related company, Universal Pediatrics.
The company and its owner, Steven Tucker Anderson, were accused of improperly billing Medicaid, according to settlement documents released by federal prosecutors Thursday. The bills included costs of entertainment and travel that were unrelated to patient care, authorities alleged. Prosecutors also alleged the bills included payments to other companies Anderson owned that exceeded what was allowed.
The company provides in-home nursing services throughout Iowa to children and young adults with serious physical problems, such as an inability to breathe without a ventilator. Medicaid is the joint federal and state health-insurance program for poor people and those with serious disabilities.
Under the agreement, Anderson and the company are to immediately pay $250,000 to the government, then pay the remaining $750,000 over three years.
U.S. Attorney Kevin Techau of Cedar Rapids, whose office pressed the case, said the company cooperated with the investigation. However, the prosecutor said the case made an important point.
“We will continue to use every resource available to ensure that all Iowa health care providers play by the same rules and that government money intended to pay for health care for Medicaid or Medicare beneficiaries is spent only for its intended purpose,” he wrote in a prepared statement.
The settlement did not include any admission of wrongdoing.
The company’s lawyer, Stephen Locher of Des Moines, said the issues stemmed from staff errors in complying with complicated Medicaid rules. He said the company has improved its billing process to avoid such problems in the future.
“Ultimate Nursing is an Iowa-based company that takes great pride in providing excellent care to its many clients throughout the state of Iowa, and has done so for the past 31 years,” Locher wrote in an email to The Register. “At no time did this investigation reveal any problems with the quality of the company's nursing care or its billing to clients. Ultimate Nursing is ready to move on from this matter and looks forward to another year as a leader in providing home health care services to Iowans.”