December 2, 2020
The owner and operator of Atlanta-based
Elite Homecare has been sentenced to over
five years in prison and ordered to pay
$999,999 in restitution for defrauding Medicaid of nearly $1 million. As a provider under the Georgia Pediatric Program (GAPP)—an in-home nursing program for Medicaid-eligible children with severe physical and cognitive disabilities—
Diandra Bankhead allegedly submitted thousands of claims for services that were fraudulent in a myriad of ways. Some of the claims falsely represented that employees provided more than 24 hours of services in a given day to multiple children simultaneously (including to children whose families had not retained Elite, and by RNs who did not know their credentials were being used), while other claims contained fraudulent credentialing information and fraudulent supporting documentation, or were upcoded to induce higher payments from Medicaid. Additionally, Bankhead allegedly “sold” information about twenty of Elite’s former clients to another Atlanta-based home health provider in exchange for a percentage of the reimbursements from Medicaid.
USAO NDGA