 |
Department of Justice United States Attorney Julia C. Dudley |
|---|
FOR IMMEDIATE RELEASE Monday, September 28, 2009 |
CONTACT: Brian McGinn PHONE: 540-857-2974 FAX: 540-857-2179 EMAIL: Brian.McGinn@usdoj.gov www.usdoj.gov/usao/vaw |
CHARLOTTESVILLE WOMAN PLEADS TO CONSPIRACY CHARGE
Pamela Kay Divine Was The Regional Administrator For Advantage Care
CHARLOTTESVILLE, VIRGINIA -- A 57-year-old local woman who served as the regional administrator for Advantage Care, a home health care provider, admitted today in U.S. District Court that she participated in a conspiracy to commit health care fraud and defraud the United States by claiming home care providers employed by her company had obtained training which they had not actually received.
“Providing trained and experienced care to the infirm and home bound is a critical component of this nation’s Medicaid program,” United States Attorney Julia C. Dudley said today. “Those who personally profit by committing fraud or not providing appropriate training to providing home care will be prosecuted to the fullest extent of the law.”
Pamela Divine ran the day-to-day operations of Advantage Care, a home healthcare company with offices in Charlottesville, Harrisonburg, Staunton, Covington, and Culpeper that provided personal care aides to Medicaid recipients. Personal care aides perform tasks such as assisting with daily activities, providing light exercise for patients and other household services. Medicaid pays for all claims related to the services of personal care aides.
Devine’s duties with Advantage Care included the marketing, hiring and managing employees including Personal Care Aides. Advantage Care was a registered home care provider with Medicaid and conducted its own personal care aide training, which requires 40 hours of training and must be completed prior to the issuance of a personal care aide certificate. These training sessions must be supervised and signed off on by a registered nurse. Advantage Care had two registered nurses assisting them.
Following a series of complaints about the training methods in place at Advantage Care, it was determined that, at the direction of Divine, a number of registered nurses working for Advantage Care were issuing personal care aide certificates to individuals who had not completed the proper training.
Divine admitted today that she provided personal care aide certificates to person with prior medical experience after they had taken a test and “tested out”of the training. This theory of “testing out” is not an approved method of allowing for certification pursuant to Medicaid regulations.
Between January 2004 and October 2005, six untrained and uncertified personal care aides provided personal and respite care for Medicaid recipients. The claims submitted by Advantage Care to Medicaid, which were eventually paid, total $120,000.
The maximum penally faced by the defendant at sentencing is five years incarceration and/or a fine of up to $250,000. A sentencing hearing has not been scheduled in this matter.
The investigation of the case was conducted by the Virginia Medicaid Fraud Unit and the Office of Inspector General, Health and Human Services. Assistant United States Attorney C. Patrick Hogeboom III and Special Assistant United States Attorney Vaso Doubles are prosecuting the case for the United States.