Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Human Care Services for Families and Children INC

Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities·Brooklyn, NY·NPI: 1730369760SharePrint Report

Red Flags Explained

Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

Cost Outlier

Cost Outlier means this provider charges significantly more per claim than other providers billing the same procedure codes. This could indicate upcoding, inflated charges, or specialized services that justify higher costs.

Billing Swing

Billing Swing means this provider's total billing changed dramatically from one year to the next — increasing or decreasing by more than 200% with over $1M in absolute change. This could indicate a change in practice scope, a billing scheme ramping up, or legitimate growth.

Rate Outlier

Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.

Explosive Growth

Explosive Growth means this provider's billing increased by more than 500% year-over-year. While rapid expansion can be legitimate, this pattern has been observed in fraud schemes that ramp up billing quickly before detection.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Advanced Detection Signals

Additional statistical tests from advanced fraud detection methods

Change PointBilling shifted 8.5x in 2022-04

These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.

Risk Assessment

Bills $469.67 per claim for H2015 (Comprehensive community support services, per 15 min) — 4.9× the national median of $96.24.

Bills $315.53 per claim for H2014 (Skills training & development, per 15 min) — 3.8× the national median of $83.88.

Billing above the 90th percentile for 2 procedure codes simultaneously.

This is a statistical summary, not an accusation. See our methodology.

Compared to Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities Peers

Total spending distribution among 19 providers in this specialty

P25MedianP75P90

This provider's total spending of $203.8M is at the 75th percentile among 19 Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities providers.

Active Billing Period:2021-092024-10(38 months)

Total Paid

$203.8M

$203,820,196

Total Claims

612K

Beneficiaries

44K

13.8 claims/patient

Avg Cost/Claim

$333

#442 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

Human Care Services for Families and Children INC is a Community Based Residential Treatment Facility Intellectual and/or Developmental Disabilities provider based in Brooklyn, NY. From the 2018–2024 period, this provider received $203.8M in Medicaid payments across 612K claims.

Why This Matters

This provider received $203.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 25,477 Medicaid beneficiaries for a full year at average per-enrollee costs.

5092% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2021
$977K
+9080%
2022
$89.7M
-30%
2023
$62.4M
-19%
2024
$50.7M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 4 distinct procedure codes. The top code (H2015 (Comprehensive community support services, per 15 min)) accounts for 48% of total spending.

H2015Top 5%

Comprehensive community support services, per 15 min

$98.5M

210K claims · 48.3%

Your Cost: $469.67/claim|Median: $96.24
4.9× median
H2014Top 10%

Skills training & development, per 15 min

$50.7M

161K claims · 24.9%

Your Cost: $315.53/claim|Median: $83.88
3.8× median
S5150Top 25%

Unskilled respite care, per 15 min

$49.7M

215K claims · 24.4%

Your Cost: $230.95/claim|Median: $84.46
2.7× median
T2015Normal range

Habilitation, prevocational, waiver, per diem

$4.9M

26K claims · 2.4%

Your Cost: $185.71/claim|Median: $88.27
2.1× median