Autism — Overview, Signs, and How to Be a Better Friend

ONLINE RESOURCES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES AND THEIR FAMILIES:

Regional Resources -

• Opelousas Area Cerebral Palsy Clinic

Louisiana Resources -

• Department of Health and Hospitals
• Louisiana Capital Area CHADD
• Louisiana Chapter of the National Ataxia Foundation
• Louisiana Department of Education
• Office for Citizens with Developmental Disabilities

National Resources -

• AUTCOM
• Autism Society of America
• Autism Spectrum Consultants
• Children with Spina Bifida
• Dyslexia My Life
• Dyslexia Online
• Families for Early Autism Treatment (FEAT)
• Institute for Applied Behavior Analysis (IABA)
• KJP's Aspergers Sydrome Page
• National Down Syndrome Society
• PAAINS
• Sensory Intergration Resources
• SkinCell International Forum
• Spina Bifida Association
• United Cerebral Palsy

Policy & Procedure

Preventing, Detecting and Reporting Fraud & Abuse

Federal & State False Claims Acts

Policy Statement: The following policy enacted by Alternative Home Care Specialists, Inc. (AHCS) is intended to educate all employees and managers on preventing, detecting and reporting fraud and abuse, as is required by federal and state laws and regulations. All employees and managers are required to adhere to this policy and conduct themselves in an ethical manner while conducting all business activity.

Fraud is defined as the intentional deception or misrepresentation made by a person with the knowledge that the deception could result in some unauthorized benefit to himself or some other person.

Federal and State False Claims Acts Prohibit:

• Knowingly presenting a false claim for payment or approval.
• Knowingly engaging in misrepresentation to obtain or attempt to obtain payment from medical assistance programs.
• Conspiring to defraud the medical assistance programs through misrepresentation or by obtaining payment for a false or fraudulent claim.
• Knowingly submitting a claim for services or supplies which were medical unnecessary or which were of substandard quality.

Practical Examples of false claims:

• Documenting hours worked other than actual hours and for billing for services that were not delivered.
• Employees or participants signing timesheets with the knowledge that the hours worked are not correct.
• Billing for unnecessary services.
• Knowingly providing inaccurate data on a cost report.

You have a responsibility to report.  All employees and contractors are required to report suspected o confirmed fraud immediately to a manager.

Alternative Home care will investigate and take the proper actions per this policy to investigate and report to the proper authorities all fraud and abuse.

Whistleblower Protections:

• All employees that report suspected or confirmed fraud will be kept anonymous and are protected as whistleblowers.
• Whistleblowers cannot be discharged, demoted, suspended, threatened, harassed or discriminated against in any manner.
• Whistleblowers my bring civil suit on behalf of the government for violations of federal and state false claims acts. The government will choose whether or not to intervene in the case. If successful the private citizen may be eligible to receive a portion the funds recovered.  If the civil suit is determined to be frivolous or brought primarily for harassment, the whistleblower may be forced to pay all court fees.

Procedures to detect and prevent fraud and abuse:

• All timesheets are verified by both the employee and the consumer (or the participant's representative).
• All notes are matched to the corresponding timesheet. Discrepancies are investigated prior to the employee being paid for the time worked and before the service is billed by Medicaid.
• The payroll department checks for overlapping shifts. Furthermore, our billing software will not allow an overlap in billing.
• When Case Managers make regular home visits, they ensure that timesheets and notes are not completed in advance.
• If at any time fraud is suspected and unannounced drop-in visit is made to the participant’s home.
• Management investigates all reports of fraud and abuse immediately and the appropriate actions are taken in accordance with this policy.

Consequences for committing fraud:

• Immediate termination of employment.
• Arrest and prosecution by authorities.
• Penalties and fines.
• Employee is reported to professional boards.
• Loss of certification or license for the DSW, CNA, LPN, RN.
• Exclusion from any Medicaid business of five years.
• Fraud is reported to Medicaid.

Federal- Three times the defrauded amount and civil penalties not less than $5,500 and not more than $11,000 for each offense.

State- The amount defrauded and civil penalties not to exceed $10,000or three times the defrauded amount, whichever is greater.

Alternative Home Care action taken once fraud is confirmed.

• Employee is terminated and reported to Medicaid.
• If Medicaid has been billed for the fraudulent act Alternative Home Care immediately notifies Medicaid and completes the proper paperwork for the funds to be recouped.

Sources:

Federal False Claims Act - False Claims Act Resource Center https://www.falseclaimsact.com
Louisiana False Claims Act - False Claims Act Recourse Center https://www.falseclaimsact.com
Common Types of Fraud - False Claims Act Resource Center https://www.falseclaimsact.com
31 U.S. Code § 3802 - False claims and statements; liability http://www.law.cornell.edu/uscode/text/31/3802

Policy & Procedure Manual
Federal & State False Claims Acts – Fraud & Abuse
July 2011; Revised September 2014

Our privacy statement

This document describes AltHomeCare.com's policy regarding information received about you during visits to our web site. The amount and type of information received depends on how you use our site.

Normal Web Site Usage:

You can visit AltHomeCare.com's web site to read the product, without telling us who you are and without revealing any personal information. The only information we collect and store during normal web site usage is the name of your (ISP) Internet Service Provider, the web site that referred you to us, the pages you request and the date and time of those requests. We use this information to generate statistics and measure site activity to improve the usefulness of customer visits. During normal web site usage we do not collect or store personally identifiable information such as name, mailing address, email address, phone number or social security number.

Collection of personally identifiable information:

There are instances where AltHomeCare.com requests personally identifiable information to provide the web site visitor a service or correspondence (promotions and mailed brochures). This information, such as name, mailing address, email address, type of request and possibly additional information, is collected and stored in a manner appropriate to the nature of the data by AltHomeCare.com and is used to fulfill your request. The information you provide is used by AltHomeCare.com to improve the services we provide you. It is never provided to any other company for that company's independent use.

Electronic Mail sent to us that contains personal information:

Internet users may decide to send AltHomeCare.com personally identifying information, for example, in a message containing information about your address. AltHomeCare.com will only use this information to identify the user as a AltHomeCare.com customer and to determine how to respond to the electronic mail. We will not use this information other than to resolve the matter identified in the email. We reserve the right to change our Privacy Policy. A revised Privacy Policy will only apply to data collected subsequent to its effective date. Any revisions will be posted at least 10 days prior to its effective date.

Rev. 1.0  March 24th 2008

Our legal statement

AltHomeCare.com strives to give you an easy-to-use site that provides accurate content, including product information, policies, pricing, and visual displays. Policies, pricing, and item availability are subject to change. Images are shown for representational purposes only. While AltHomeCare.com tries in good faith to make sure the information on our ‘site’ and information published at 'other sites' which are linked from here on the Internet is accurate, we are not responsible for typographical errors or technical inaccuracies. This disclaimer in no way affects the terms of any manufacturer's warranty.

Note: Links are listed here as a convenience to you and in no way imply an endorsement of these services.

Trademarks

 
All product names and company logos mentioned herein remain the trademarks of their respective owners. © 2008 - All Rights Reserved, Alternative Home Care Specialist, Inc.

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Billing coordinator

Contact: cmouton@AltHomeCare.com

Billing, AR, invoices, staffing review, and compliance are daily functions for the billing department which Cindy manages.

Registered Nurse

Contact: gberthelot@AltHomeCare.com

Gloria takes the home care service to a new level of care by providing the level of professional nursing care which almost no other agency employs. With director of nursing credentials for hospitals and several years with Alternative, Gloria brings the home care we provide to a standard well above the norm.

Records Coordinator

Contact: lknott@AltHomeCare.com

Loraine has added her cheer and efficiency to the office of Alternative for many years.