3 charged with Medicaid fraud

Three Jackson County individuals have been arrested on charges of defrauding Medicaid, Attorney General Bill McCollum announced in a news release Wednesday.
According to the news release, the three conspired to defraud the Florida Medicaid program out of at least $112,000.
Frederica Bell Hill, Cathy Summerlin and Larry Roger Hill, all of Cottondale, were arrested by the Attorney General’s Medicaid Fraud Control Unit, with assistance from the sheriffs’ offices in Jackson and Calhoun counties.
The Hills were taken into custody Tuesday; Summerlin was arrested Wednesday morning.
Cottondale resident Frederica Hill, 41, is a licensed practical nurse employed by Interim Home Health Agency to provide 40 hours of skilled nursing per week to a Medicaid recipient.
Medicaid fraud investigators received information from the Department of Children and Families’ Adult Protective Services in late 2004. Hill allegedly entered into a verbal agreement with Cathy Summerlin, 43, the mother of the Medicaid recipient, to falsify service records indicating Hill was providing services to Summerlin’s son while Summerlin lived in Cottondale. Summerlin has since moved to a nearby community.
After obtaining the falsified service logs from Summerlin, Mrs. Hill would allegedly submit the logs to her employer, which submitted the claims to the Medicaid program for reimbursement.
According to the news release, from Jan. 1, 2005 until Dec. 15, 2008, Hill was paid more than $112,000 for services she allegedly never provided. Frederica’s husband, Larry Hill, 41, also of Cottondale, allegedly had knowledge of the agreement and made payments to Summerlin for her participation in the scheme.
Frederica Hill is charged with Medicaid provider fraud, organized fraud, communications fraud, grand theft, neglect of a disabled adult and conspiracy to commit Medicaid provider fraud. If convicted, she faces up to 80 years in prison and up to $40,000 in fines.
Cathy Summerlin is charged with Medicaid provider fraud, organized fraud, communications fraud, neglect of a disabled adult and conspiracy to commit Medicaid provider fraud. If convicted, she faces up to 50 years in prison and up to $30,000 in fines.
Larry Hill is charged with Medicaid provider fraud and conspiracy to commit Medicaid provider fraud. If convicted, he faces up to 10 years in prison and $10,000 in fines.
Bond for Frederica Hill was set at $30,000 at her first court appearance. Bond for Larry Hill was set at $10,000. Summerlin was still awaiting first appearance as of Wednesday.
The case is being prosecuted by the State Attorney’s Office for the 14th Judicial Circuit.

Affidavit provides
more details
According to investigative notes in the affidavit filed in connection with the arrests, for several years Hill was supposed to be providing 40 hours of care each week to Summerlin’s quadriplegic son.
But around the start of 2005, she allegedly told Summerlin she could no longer provide that level of service because she had a full-time job as a nurse at Apalachee Correctional Institution in Sneads, and she also wanted to spend more time with her family.
A verbal agreement between Mrs. Hill and Summerlin was allegedly reached. Under the terms, Hill would pay Summerlin $150 a week to participate in a scheme which would allow Hill to continue being paid for care she did not deliver. Summerlin allegedly agreed to sign off on falsified service logs that Hill then turned in to her employer.
The report goes on to note that Hill admitted she also sometimes signed Summerlin’s named to such documents.
The affidavit notes only one instance in which Hill provided actual care, during the week of July 4, 2008.
According to the investigative notes, Summerlin called Hill three times around that time, to report that her son had a wound that needed attention. Hill responded after the third call, coming to the home to dress and care for the wound. She also brought supplies and showed family members how to take care of it as it healed.
During the course of the arrangement, Larry Hill sometimes brought the $150 checks to Summerlin. Investigators say he was fully aware of and participated in the scheme.
The Hills also allegedly made some of Summerlin’s rent payments, and took care of other bills several times over the years after Frederica Hill had convinced the landlord to rent to Summerlin.
According to the affidavit, Hill paid Summerlin’s gas bill or other expenses in lieu of the $150 check, or as part of the payment. Larry Hill also occasionally mowed the grass around Summerlin’s dwelling, and the Hills paid for her satellite TV hook-up as well as some of the monthly service charges. They also provided Summerlin with a clothes dryer.
According to the affidavit, Hill had rented the Summerlin dwelling several years earlier herself and, according to the landlord, in 2005 went to the owners and “insisted that they rent the home to the Summerlins, as they needed a place to live.”
The landlord acknowledged that the Hills had made Summerlin’s rent payment, and paid other expenses several times over the years.
The deal between Hill and Summerlin was sometimes rocky.
According to the affidavit, Summerlin would sometimes complain when she didn’t receive her $150 weekly payment on time, or if not enough was paid by Hill to those Summerlin owed money.
At times, the report stated, Summerlin threatened to “go to the law” if she didn’t get the amount she felt she was owed by Hill.
The issues came to light in 2008, and an investigation ensued after an adult protective investigator with the Florida Department of Children and Families filed a complaint. In it, the investigator alleged that Summerlin’s son “may have been the victim of neglect by his caregivers and there was Medicaid fraud being committed by” the Hills and Summerlin.
The matter was over to the Office of the Attorney General. That agency assigned a Medicaid Fraud Control Unit investigator to the case in mid-2008.
The affidavit alleges that Frederica Hill was paid approximately $112,999 by her employer, who had submitted her reports for Medicaid payments. The employer was not implicated in the scheme, but had received $196,933 in Medicaid payments based on the reports Hill had filed during the periods between January 2005 and December 2008.
The affidavit indicates that Hill stated that she been assigned to care for Summerlin’s son since 2002. But the report does not fully address the level of care during that period.