Brittany Nicole Benson

Your affiant, Angelica Weidemann, is a Supervising Investigator with the Medicaid Fraud Control Unit (MFCU) of the Minnesota Attorney General’s Office. As Supervising Investigator for the MFCU, I investigate allegations of billing fraud by health care providers enrolled in the Minnesota Medical Assistance (Medicaid) Program, as well as supervise investigators handled by other MFCU investigators. MFCU investigators investigated Brittany Nicole Benson [DOB REDACTED] (B. BENSON), the defendant herein, and B. BENSON’s work as a Personal Care Assistant.

Investigators determined that B. BENSON defrauded the Medicaid program by submitting time sheets for services that she did not provide. As a result of these false claims, the Minnesota Department of Human Services paid out $87,309.26 in Medicaid funds, $61,657.76 of which B. BENSON was paid in wages. I. THE MEDICAID PROGRAM The Medicaid program provides medical care and services to Minnesotans (recipients) who meet certain income and other eligibility requirements. The Medicaid program, known in Minnesota as the Minnesota Health Care Programs (MHCP), is administered by the Minnesota Department of Human Services (DHS). The DHS enrolls health care providers to furnish health care services and goods to Medicaid recipients.

Medicaid providers are informed of the laws and regulations governing their participation through the MHCP Provider Manual (Manual), which provides specific information for each provider type. For instance, providers must submit claims only after services are rendered and cannot submit claims that overstate either the level of care provided, or the amount of care provided. Medicaid covers personal care assistant (PCA) services, which include assistance with activities of daily living like dressing, grooming, bathing, eating, mobility, and toileting.

Under Medicaid guidelines, personal care services are provided by a PCA, who is employed by a Personal Care Assistance Services Agency (Agency) for the purpose of providing personal care necessary to maintain a recipient in his or her residence. A PCA is required to accurately document the time he or she spends with a recipient on a timesheet. The PCA then submits the timesheets to the Agency, which bills the DHS for services based on the information reported in the timesheet. Homemaker services are also covered by Medicaid.

Homemaker services are provided to recipients for their home management and cleaning needs. Like PCA services, homemaking services must be documented on a time sheet and provided in the recipient’s home. A person receiving homemaker cleaning services is not required to be present while their home is cleaned. However, the recipient must be present for the provider to deliver homemaker home management and homemaker assistance with activities of daily living (“ADLs”). The timesheets reflect the type of homemaking service that is being provided.

Medicaid also offers a shared care option for recipients of PCA services. Shared care services are provided in the same setting at the same time by the same PCA for multiple recipients. Shared care PCA payment rates, which are different from individual PCA service rates, apply if a PCA is providing shared care services. Shared care services must be approved by an assessor before the services are rendered. Additionally, any recipients receiving shared care services must have signed the Home Care Shared Services Agreement and been approved by the Agency for shared care services.