Owner of Home Health Services Agency and Parent of Disabled Child Arrested for Medicaid Provider Fraud

TALLAHASSEE, Fla.-Attorney General Ashley Moody's Medicaid Fraud Control Unit announced the arrest of the owner of a home health services agency and a parent of a disabled child for Medicaid provider fraud. Latrena Marie Thomas is the owner of A River's Journey, a home health care agency with residential home care facilities located in Yulee and Jacksonville. Thomas is accused of hiring non-licensed individuals to provide hands-on personal care services to Medicaid recipients. In addition, Thomas paid Donald Ray Adams II, a parent of a disabled Medicaid recipient, to provide medically licensed care for his own child. In total, Thomas fraudulently billed Medicaid claims for 30 distinct medically needy Medicaid recipients, which caused a total loss of more than $1.6 million.

Attorney General Ashley Moody said, "This fraudulent billing scheme not only defrauded the Florida Medicaid program out of more than $1.6 million but did so at the expense of Medicaid-dependent recipients, one being a disabled child. In addition to manipulating the system for extra money, the hiring of unqualified and unlicensed medical staff resulted in poor treatment and medical emergencies for Medicaid patients. I'm grateful for our Medicaid Fraud Control Unit for putting a stop to this scheme."

According to the investigation, Thomas and the agency hired employees not licensed as certified nursing assistants or home-health aides to provide hands-on personal care to Medicaid recipients. Several of these unqualified employees would have failed the Level 2 background screening that is required by the Florida Agency for Health Care Administration. Thomas did not have a Director of Nursing on staff to provide oversight of the licensed practical nurses and other staff employed by A River's Journey. Thomas also falsified the agency's employee roster, progress notes, service logs and plan-of-care documents, and billed for a recipient's 24/7 nursing care while paying Adams. Thomas's negligent assignment of unqualified staff to recipients created three separate medical emergencies, including a trach tube dislodging, extreme sunburn and a delay in contacting Emergency Medical Services.

A River's Journey paid Adams for providing unsigned progress notes for his own child's care. Adams received payments in cash, gift cards and bank deposits from the agency. In total, Adams received $7,320 for involvement in the scheme to defraud Medicaid.

Thomas faces one count of Medicaid provider fraud, $50,000 or more: a first-degree felony. Adams faces one count of Medicaid provider fraud, $10,000 or less: a third-degree felony.

The Jacksonville Sheriff's Office arrested Thomas and the Clay County Sheriff's Office arrested Adams. Attorney General Moody's MFCU will prosecute the case through the State Attorney's Office for the Fourth Judicial Circuit.

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The Florida Attorney General's Medicaid Fraud Control Unit investigates and prosecutes providers that intentionally defraud the state's Medicaid program through fraudulent billing practices. Medicaid fraud essentially steals from Florida's taxpayers. Additionally, the MFCU investigates allegations of patient abuse, neglect, and exploitation in facilities receiving payments under the Medicaid program.

The Florida MFCU is funded through a grant totaling $29,707,695 for Federal Fiscal Year 2024, from the U.S. Department of Health and Human Services-Office of Inspector General. The Federal Share of these funds is 75% totaling $22,280,772. The State Matching Share of these funds is 25% totaling $7,426,923 and is funded by Florida.