Protecting Medicaid. Protecting Our Clients. CareChoice’s Commitment to Integrity.

Our Commitment to Fighting Fraud While Protecting Those Who Need Care Most

Across the country, government agencies are increasing their efforts to investigate and eliminate Medicaid fraud. At CareChoice, we welcome these efforts.

Every dollar lost to fraud is a dollar that cannot be used to care for seniors and individuals with disabilities who depend on home care services to remain safe, independent, and living in their own homes. We believe protecting the integrity of the Medicaid program is one of the greatest responsibilities of every healthcare provider.

At the same time, it is important to remember that the overwhelming majority of Medicaid recipients are honest individuals who simply need assistance with daily living. These services allow them to remain in their communities, maintain their independence, and avoid unnecessary nursing home placement.

Unfortunately, a small number of bad actors abuse the system. Their actions threaten public trust and divert valuable taxpayer resources away from those who truly need care. CareChoice believes these individuals should be identified, investigated, and held accountable.

Zero Tolerance for Fraud

CareChoice maintains a zero-tolerance policy toward Medicaid fraud, waste, and abuse.

If we discover evidence of fraudulent activity involving our services, our employees, caregivers, clients, or any other party, we are committed to reporting it to the appropriate authorities. Protecting the integrity of the Medicaid program is not simply a regulatory obligation—it is part of our mission.

Investing in Technology and Oversight

Rather than doing only what is required, CareChoice has invested in additional safeguards designed to detect, prevent, and reduce fraud before it occurs.

These measures include:

• Real-Time Hospital Admission Notifications – Through our Health Information Exchange integration, CareChoice receives near real-time notifications when clients are admitted to or discharged from participating hospitals. This allows us to immediately pause home care services during hospital stays, helping prevent duplicate billing and ensuring Medicaid is billed accurately.
• Electronic Visit Verification (EVV) – CareChoice consistently maintains an EVV compliance rate above 85%, helping verify that caregivers are present when services are provided and that visit documentation is accurate.
• Regular Supervisory Visits – Our clinical and supervisory staff conduct ongoing in-home visits to verify that services are being delivered appropriately, assess client well-being, and ensure care plans continue to meet each individual’s needs.
• Routine Wellness Calls – We regularly contact clients and their families to confirm satisfaction with services, identify concerns early, and verify that scheduled care is being provided as expected.
• Continuous Compliance Monitoring – Our quality assurance and compliance teams routinely review documentation, investigate irregularities, and provide ongoing education to employees and caregivers regarding fraud prevention and ethical practices.

Our Commitment to Clients

While fraud prevention is essential, our first commitment will always be to the people we serve.

Home care is far more than a healthcare service—it is what allows thousands of individuals to continue living with dignity in the place they call home. For many older adults and individuals with disabilities, these services mean avoiding institutional care, remaining close to family, and maintaining independence.

Our goal is to ensure that every eligible person continues to have access to these vital services while helping preserve the Medicaid program for future generations.

Working Together

Fighting Medicaid fraud requires cooperation among providers, managed care organizations, government agencies, caregivers, clients, and families. CareChoice is proud to be part of that effort.

By embracing technology, maintaining strong compliance programs, and fostering a culture of accountability, we are helping protect taxpayer dollars while ensuring that those who genuinely need care continue to receive it.

At CareChoice, we believe integrity and compassion go hand in hand. We remain committed to delivering exceptional care, protecting public resources, and doing our part to strengthen the Medicaid program for everyone.