BLAKES BLESSING HEALTH CARE INC.

BLAKES BLESSING HEALTH CARE INC. is an organization in Houston, Texas, that bills Texas Medicaid for home and community based attendant care. Texas records list the company on the state Medicaid exclusion list with an action date of January 19, 2022. Even so, Medicaid payment records show claims paid in 33 later service months, from February 2022 through October 2024, totaling $2,118,903. In the twelve months before the exclusion action, the provider was paid $1,683,327. Every Medicaid dollar for this provider falls on one code, attendant care services per fifteen minutes, at $932 per patient-month, which is below the typical $1,759 for that code.

1. 01NPI 1679896484 is BLAKES BLESSING HEALTH CARE INC., an organization in Houston, TX, with taxonomy 251E00000X and a Medicaid home state of Texas. records 1
2. 02The provider has been listed on the Texas Medicaid exclusion list since January 19, 2022, per the Texas HHSC OIG Exclusions file dated September 5, 2026. records 3, 4
3. 03After the Texas state exclusion action dated 2022-01-19, Medicaid paid $2,118,903 across 33 service months, from 2022-02 through 2024-10. records 3, 4
4. 04Medicaid paid this provider $1,683,327 in the 12 months before the exclusion action. records 4
5. 05Code S5125 (Attendant care services per 15 min) accounts for $914,338 paid over 19 months and 100% of this provider's Medicaid dollars, and this code family has a history of abuse. records 2, 3
6. 06The provider's S5125 billing is $932 per patient-month, which ranks at the 24th percentile of all providers billing this code, where the typical figure is $1,759. records 2
7. 07The record is assigned evidence tier 1 (documented action, then payment) with detector D3 and dollars at risk of $2,118,903, described as the figure of the detector that set the tier rather than a sum. records 3

Request from the Texas Medicaid agency the current enrollment record for NPI 1679896484, including the enrollment and revalidation history, any denial or termination action taken after January 19, 2022, and any appeal, stay or reinstatement that may have restored payment eligibility. Obtain the full exclusion record from the Texas HHSC OIG Exclusions file, including the action date, basis and any end date, and confirm whether the excluded party is the entity itself or an affiliated owner or manager. Pull the paid claims detail for service months 2022-02 through 2024-10 supporting the $2,118,903, with dates of service, member identifiers, rendering attendant identifiers and the paid amounts on code S5125, and reconcile against service authorizations, attendant time sheets and electronic visit verification records. Run the routine exclusion and identity checks required by 42 CFR 455.436 against NPPES, the LEIE and SAM, and document the monthly LEIE and SAM check results for the period in question. Refer to the state Medicaid agency for an enrollment determination under 42 CFR 455.416(c). If the review develops a credible allegation of fraud, the state must consider a payment suspension under 42 CFR 455.23(a) and make the referral to the Medicaid Fraud Control Unit required by 42 CFR 455.23(d).

• The exclusion may have been appealed, stayed, overturned or followed by a reinstatement that lawfully restored payment eligibility, and the exclusion file extract is dated September 5, 2026, so an end date may not be reflected in the line reviewed.
• The exclusion listing may match an affiliated individual, prior owner or a similarly named entity rather than the billing organization, so identity matching must be confirmed before any conclusion.
• Payments in later service months can reflect claims for dates of service before the action date, run out or retroactive adjustments, cost settlements or data lag between the exclusion file and the claims system.
• Attendant care agencies commonly bill a single code because that is the only service they are authorized to deliver, so 100% concentration on code S5125 can be normal for this provider type.
• Per patient-month billing of $932 sits at the 24th percentile and below the typical $1,759, which is not an overutilization signal on its own.
• The dollars at risk figure of $2,118,903 is the detector figure that set the tier and is not a calculated overpayment amount.
• Supervisory or agency level billing conventions may place all claims under the organization NPI even where multiple attendants furnished the care.