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RN settles fraud claims for $1.66M, but license is still clear

Two years ago, the Florida Attorney General’s Office filed suit against registered nurse Elizabeth Venters, accusing her and her home-health agency of massive fraud against the Medicaid program.

The case against Venters ended four months ago, court records show, after she settled for $1.66 million and was excluded from the Medicaid program.

Today, though, her nursing license in Florida is still marked “clear and active.” There are no pending complaints listed on the Department of Health website.

Meanwhile, Venters has moved to Kentucky, where she has the kind of nursing license that enables her to work in any of 24 states.

The Kentucky Board of Nursing checked databases where any action against Venters would have shown up, said general counsel Nathan Goldman. Nothing did.

Such delays are common, Goldman said. Until Florida’s Board of Nursing acts and reports the action to the data banks, he said, “there’s not anything we can do about it.”

While the dollars are bigger in Venters’ case than most, it is far from unusual. Florida health-care professionals often get into trouble – sometimes really big trouble – yet their licenses remain clear and active for years, or forever.

A Health News Florida investigation indicates that can happen for a number of reasons.

The Department of Health, which is supposed to investigate and prosecute complaints, sometimes lacks statutory authority to pursue a case. Sometimes DOH drops the ball. Or it prepares a case, but the screening committees for the boards – dominated by members of the profession – decide there isn’t enough evidence of wrongdoing to find “probable cause” that there was a violation of law.

In such cases, no record is ever made public. Investigative files are kept secret.

So, it is possible that DOH was never told about the Medicaid fraud investigation and suit against Venters, her home-health agency All Caring Nurses, and her housemate Christine Whiteley, who served as vice-president.

The Attorney General’s Office hasn’t notified DOH of the Venters settlement, said spokeswoman Jenn Meale, because the state hasn’t been able to strike an agreement with Whiteley.

It’s unclear how long that will take, Meale said, because Whiteley is “in default.”

Venters’ attorney in the case, Kevin Darken, declined to comment or put a reporter in touch with his client.

The state accused Venters’ agency, which catered to disabled Medicaid patients, of “upcoding.” According to the complaint, the agency routinely sent out licensed practical nurses (LPNs) but billed Medicaid for registered nurses, generating a higher payment. This went on for years, the complaint said.

At first, court records show, Venters denied defrauding Medicaid, saying her reimbursement claims were accurate. If there were mistakes, she said, they weren’t deliberate.

But eventually the case was settled and filed in the Hillsborough Circuit Court. That was in December, two months after Venters lost her Odessa home to foreclosure.

By then, according to the address she gave to Florida DOH, she had moved to Salyersville, Ky, and obtained an RN license. No information was available on where she may be working

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.