Floracare Anti-Fraud Policy

Consumer Directed Services (CDS) Fraud Prevention & Reporting Policy Floracare has zero tolerance for fraud in any form. As a Missouri CDS provider, we strictly follow the guidelines set by Missouri Medicaid Audit & Compliance (MMAC), Mo HealthNet, and all federal regulations. Fraud by caregivers, consumers, staff, or outside parties will result in immediate action.

A nurse explains medication to an elderly man at home.

What Is Fraud?

Fraud is any intentional act meant to deceive for financial gain or to avoid proper compliance. In the CDS program, fraud includes, but is not limited to:

Submitting false EVV records
Caregiver clocking in/out without being physically present
Turning off GPS or using GPS spoofing tools
Going to school, working another job, or running errands while clocked in
Having someone else clock you in/out
Subcontracting your job (sending someone else to do your CDS duties)
Billing for services while the consumer is in the hospital, rehab, or out of town
Clocking in at two places at once

EVV Policy (Effective Immediately)

No timesheets. Floracare uses EVV only.
Caregivers must clock in/out using Floracare's EVV app or a landline phone connected to the wall at the consumer's home.
Caregivers must be physically present. Location services (GPS) must be ON at clock-in/out.
Consumers cannot clock in/out for caregivers under any circumstances.

· Cell phones are not valid for landline check-ins. Only wall-connected phones may be used.

Zero-Tolerance Policy

Floracare considers fraud a criminal offense. We will take swift action, including: · Immediate termination of caregiver or consumer agreements · Reporting to MMAC, Mo HealthNet, DHSS, and law enforcement · Fines, penalties, and repayment of fraudulent wages · Permanent disqualification from the CDS program · Prosecution and civil/criminal charges

Legal Consequences of CDS Fraud

Under RSMo § 191.905, Medicaid fraud in Missouri may result in:

Offense Type	Value of Fraud	Legal Charge Fine	Prison Time
Class A Misdemeanor	Under $750	Misdemeanor Up to $2,000	Up to 1 year
Class D Felony	$750 to $25,000	Felony Up to $10,000	Up to 7 years
Class C Felony	Over $25,000	Felony Up to $10,000 or double the gain	3 to 10 years

Plus:

Repayment of all Medicaid funds fraudulently obtained.
Disqualification from working in any Medicaid-funded program
Potential federal charges if the fraud crosses state/federal lines

Frequently Asked Questions (FAQs)

Can a caregiver clock in while at school or another job?

No. Caregivers must be physically providing care. Going to school, attending work, or running errands during shift hours is fraud.

Can someone else cover my shift or clock in for me?

No. Only the caregiver hired and approved by Floracare can provide care. Subcontracting is illegal.

What if the caregiver is running late or forgot to clock in?

Call Floracare immediately. Do not back-date or falsify EVV entries. All corrections must be logged and approved.

Can I provide care while the consumer is away, in the hospital, or with family?

No. You can only provide care when the consumer is at home or in a community setting.

Mandated Reporter Statement

Floracare staff are mandated reporters. We are legally required to report:

Fraud or misuse of Medicaid funds
Abuse, neglect, or exploitation of vulnerable adults
Tampering with EVV or falsifying documents

Access for All CDS Clients and Caregivers

This policy is included in all onboarding packets and will be:

Signed and dated during intake
Provided upon request
Posted publicly on the Floracare website at www.floracaremo.com → CDS Policies → Anti-Fraud Policy