Fraud investigation uncovered abuse that led to death in 'tragic, inexcusable' case
While healthcare fraud is often companioned by crimes such as identity theft, money laundering and obstruction of justice, news came today of a case in Hawaii where Medicaid fraud was connected to manslaughter.
Calling it "a classic case of elderly neglect," Hawaii's Acting Attorney General Diane Taira announced that home care provider Jennifer Polintan pleaded guilty to manslaughter for her role in the death of 88-year-old Nona Mosman, according to the Hawaii Reporter.
Mosman was a client in Polintan's licensed Community Care Foster Family Home. Mosman was bedridden and depended on Polintan for daily living activities including eating, going to the bathroom, hygiene and self-maintenance, KITV reported. Further, Mosman was prone to bed sores and needed repositioning every two hours to decrease the risk of developing ulcers, according to the Reporter.
But an investigation by the state's Medicaid fraud control unit found that Polintan was employed full-time at Schofield Barracks. That work obligation took her away from the foster home for 10 hours every Monday through Friday, the station noted.
In violation of state licensing rules for community care foster homes, Polintan left Mosman in the care of others who were neither qualified for nor capable of implementing her plan of care, the Reporter noted.
As a result of Polintan's neglect, Mosman's health quickly declined, leading to in her death in May of last year, KITV reported.
"When someone makes a conscious decision to bring a dependent adult into their home under the guise of providing care and is getting paid [by Medicaid] to provide that care," Taira told the Reporter, "then it is inexcusable and can have tragic consequences when they fail to do so."
Under the terms of her plea agreement, Polintan will serve one year in prison and pay fines, court costs and restitution to both Mosman's family and the state.
This case is a variation on a theme reported by FierceHealthPayer: AntiFraud: Elder abuse and healthcare fraud intersect when criminals claim payment for required services not provided or for unnecessary care. Both practices can victimize patients.
For more:
- here's the KITV article
- read the Hawaii Reporter article
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The link between healthcare fraud and elder abuse
'Spry spy' leads Medicaid facility fraud sting
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