The job of a Medicaid fraud investigator is to try to identify health care providers who are improperly taking money from the Medicaid system. Medicaid is a form of health insurance for lower income people, so a lot of Medicaid fraud involves things like billing for health services that were not provided or billing too much for treatments that were offered.
However, Medicaid has also become one of the primary payers of nursing home care. Nursing homes are extremely costly and many seniors cannot afford these facilities on their own so instead end up relying on Medicaid to pay the bills. Because Medicaid pays for nursing home care for a large percentage of nursing home residents, fraud investigators can work not only to identify situations where the government is losing money, but also situations where nursing home residents are being mistreated.
Identifying abuse and neglect in nursing homes is difficult because many of the victims have debilitating problems like Alzheimer’s that affect their ability to speak out for themselves. Anything that can help to find nursing homes that mistreat patients is extremely important. Those who suspect that someone they love is being victimized by abuse can also contact an Atlanta nursing home abuse lawyer at Sammons & Carpenter, P.C. for help investigating nursing home abuse and pursuing a claim for compensation.
Medicaid Fraud Investigators Can Help Identify and Stop Atlanta Nursing Home Abuse
The Baltimore Sun published a recent article showing how Medicaid fraud investigators can help in the fight against elder abuse. In this particular case, the Medicaid investigators launched an investigation into a group residential home that was supposed to provide round-the-clock care for handicapped children. The investigation was triggered because of the death of a 10-year-old disabled foster child.
Investigators contacted a guardian for a former resident of the group home, who had been hospitalized earlier because of bedsores that became infected. The investigators also contacted former employees of the facility to ask about the cleanliness of the group home, how many people were working there, and what types of medical supplies were available.
The investigation revealed that the contractor running the facility had a pattern of experiencing problems including insufficient staffing, deficient medical care, and poor fiscal management. Despite this track record, the company had been awarded $18 million in contracts to run group homes for the disabled.
The investigators will continue to look into the group home to build solid evidence of whether the home was properly managed and providing adequate care.
This type of investigation can also be conducted against nursing homes, which are required to comply with Medicaid requirements in order to continue receiving funding. Medicaid investigators can use their resources and investigatory abilities not just to save the government money for fraudulent care but also potentially to save lives.
Elder abuse and neglect remain serious problems in Atlanta and nationwide. If you or someone you love is a victim, contact an Atlanta nursing home abuse lawyer right away.
The Atlanta nursing home abuse lawyers at Sammons & Carpenter, P.C. can represent you after an injury caused by abuse or neglect. Call today at (404) 814-8949 or contact us online to schedule your free consultation.