Is my nursing agency cheating me from medicaid payments?

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    I've worked with an agency in Virginia for almost a year and for apast 10 months, i have been with the same clients and really love and care about them. I have been getting the same rate, which is $23.00/hr for one client and $32.00/hr for a brother and sister ( my agency called it congregate billing). I work about 70 hours a week, and i had been sick so i was not able to turn in previous hours worked. Last Friday I went in to turn my hours, and i had a combined total of about 320 hours. When i went in they tried to hand me a paper for me to sign. They said since August that they had made pay cuts and that my $32.00/hr was going to be cut down to $25.00 because there was another nurse that was working with 3 kids and she was getting paid $25.00/hr. They also said that my $23.00/hr is going to be cut down to $21.00 because my client is not a vent case. I told them thanks for telling me and asked when they were going to start the change. The thing that made me upset is that they said they were going to apply those changes to my 320 hours I already worked. I told them it was unfair, because they had never told me that I was getting a paycut, and that I have rent, and school fees to pay. I really love and care about my clients and their families, but I do not think my agency is being fair. Also they have this rule now that time sheets after 30 days wont be paid, and they did that with 48hours i had worked before. i was very sad about that and felt its because I am so much younger. I know for a fact they are billing medicaid and I am not getting paid. Please help me!! I love my cases and I want to stay with my clients but is my agency legally or morally right?
    lindarn likes this.
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  3. 12 Comments so far...

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    I'd make an immediate call the labor board. They have to pay you the hours your worked. I also don't think they can make the change in pay retroactive. Make the call and try and get all the money you are owed to date.
    lindarn and Vito Andolini like this.
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    Medicare/medicaid fraud is serious business. Call medicaid if you are SURE they are billing medicaid/medicare for hours never worked and ask to speak to the fraud division.
    lindarn and Vito Andolini like this.
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    Wow. You have thirty days to turn in your time sheets? Do you get paid on a monthly basis? You turned in 320 hours all at once so that covers about four and a half weeks or so and some of these hours fell outside the thirty day turn in window. You might be guilty of violating company policy and subject to whatever disciplinary action they choose, however, withholding pay is not legal in my state. As far as the pay cuts are concerned, that would depend on what efforts they made to inform you of this before you actually accepted those shifts. One of my patient's payer source changed at one time and we knew this could bring about decreased reimbursement and subsequent pay cut, but we didn't know when and how much. So I get this call Friday evening telling me starting Sunday my pay would be $2.50 less per hour. I informed them that I had not accepted any shifts at that pay rate and was not interested in doing so. I did not work Sunday and got a call Monday morning asking me if I would continue to work my scheduled hours at the previous rate until they could find another case for me. I don't take my job/hours for granted, it is my livelyhood, and for that reason I demand that others respect it too.
    lindarn, Vito Andolini, and Elektra6 like this.
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    Quote from nerdtonurse?
    Medicare/medicaid fraud is serious business. Call medicaid if you are SURE they are billing medicaid/medicare for hours never worked and ask to speak to the fraud division.
    That's actually excellent advice. Definitely make this call ASAP.
    lindarn likes this.
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    Thanks For the responses. I will try to call the labor board tomorrow @ Batman24. I did not think they could apply it to retro hours worked. Yes you are right that is about 5 weeks of work. I was admitted in the Hospital 2 times this month and did not turn them in. Plus even though it was personal problems, I had reached out to my LPN supervisor and explained to her that through my separation,my husband had bleached all my property and I there fore had to use the duplicates to rewrite everything. I did not feel I should related that message to everyone else and thats why i talked to her and explained this to her. This has been the hardest month for me and i was actually thinking of just quitting and taking a break but both parents called me personally when the agency told them i was going to and i just felt that being a nurse i was entitled to and as dedicated as i am to my clients, i should never let my personal issues get in the way. So i went back. And its just stressful that a week after THEY called me back they are doing this to me. And I do live according to my wages, being single now and paying rent, insurances (health car dental) and enrolled in school to. So if this happens..i will have to cut out some of my expenses. @ systoly
    lindarn likes this.
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    I wouldn't be so quick to accept the lower hourly wage. Holding firm like systoly did could get you the higher wage and buy you some time. Call some other agencies and see what it out there.
    lindarn and Vito Andolini like this.
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    Quote from PrettyLoyalLPN
    Thanks For the responses. I will try to call the labor board tomorrow @ Batman24. I did not think they could apply it to retro hours worked. Yes you are right that is about 5 weeks of work. I was admitted in the Hospital 2 times this month and did not turn them in. Plus even though it was personal problems, I had reached out to my LPN supervisor and explained to her that through my separation,my husband had bleached all my property and I there fore had to use the duplicates to rewrite everything. I did not feel I should related that message to everyone else and thats why i talked to her and explained this to her. This has been the hardest month for me and i was actually thinking of just quitting and taking a break but both parents called me personally when the agency told them i was going to and i just felt that being a nurse i was entitled to and as dedicated as i am to my clients, i should never let my personal issues get in the way. So i went back. And its just stressful that a week after THEY called me back they are doing this to me. And I do live according to my wages, being single now and paying rent, insurances (health car dental) and enrolled in school to. So if this happens..i will have to cut out some of my expenses. @ systoly
    It sounds like your agency is jerking you around. Whether or not the agency is fooling around with medicaid payments, their retroactive pay cut sounds crazy to me.

    Please consider taking care of yourself FIRST. If that's not done, you will not be able to take care of your clients. If you need a break, take a break. If this means switching agencies, so be it. Please don't run yourself through the wringer for your agency.

    Please also consider that your agency may be using your bond with your clients AGAINST YOU. Why do you think your agency told your clients that you were leaving? I guess I could be hopeful that it was for the benefit of the clients, but given my suspicious nature (especially since both parents directly contacted you), I sort of doubt it. Your agency may have been playing your clients against you, hoping that you would stay on the payroll (at a lower pay rate).

    Please take care of yourself.
    PrettyLoyalLPN, systoly, and lindarn like this.
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    In some sense, you are maybe too attached to the patients. I understand you like them and it's mutual. But you can't afford to let that keep you from getting paid what you are owed.

    Immediately call the state or federal labor board. Get the number from your state Congressman's or senator's office or the Governor's office or some department like that. You must stand up to these employers and let them know you are working to make a living, not to feel good about your work - although that's great if you can do both. One is necessary to survive, the other helps you thrive.

    It's a rough world, filled with all types of con artists. You seem to be working for some. Screw their 30 day "rule" about not getting paid if you turn your time card in late, especially if you were sick/hospitalized!!!!!

    Stuff like this makes me very angry but I hope you keep calm and don't go off on them. Just try to keep your job but let them know you mean to get paid and paid what you contracted for. Get a lawyer, if need be. Contact the labor board first. It's free.
    systoly and lindarn like this.
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    Sorry in advance for changing the subject somewhat. i was reading some of the topics and saw "is my nursing agency cheating me". anyways, i'm working prn through an agency while i'm in nursing school. it's a great agency with ok pay for CMT/CNA's. what i don't like is that they charge a $5.00 fee for us to get our check. another agency that i used to work for did the samething but it was $2.00. i've worked through agencies in the past and never had them charge me to get money that i worked for. what do you all think of this practice and if you're working for an agency do they charge you to get your money?
    lindarn likes this.


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