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False Claims Act Developments: Sixth Circuit Rules that Timing Matters When It Comes to Certifying Plans of Care

Posted  06/21/18
By Leah Judge Reaffirming the importance of patient plans of care, the Sixth Circuit recently held that the timing of a physician’s certification of such plans is material to the government’s decision to pay for home health services. The case marks another circuit court’s application of the materiality standard announced in Universal Health Servs., Inc. v. United States ex rel. Escobar, and serves as a rebuke...

Michigan Home Health Agency Owner Pleads Guilty to Health Care Fraud Charges

Posted  05/18/18
The owner of a Michigan home health agency pleaded guilty to fraud charges for his role in a scheme involving approximately $8 million in fraudulent Medicare claims for home health services that were procured through the payment of illegal kickbacks. Zahir Shah, 48, of West Bloomfield, Michigan, pleaded guilty to one count of conspiracy to commit health care fraud and wire fraud and one count of conspiracy to pay and...

Chemed to Pay $75 Million to Settle False Claims Lawsuit

Posted  10/31/17
By the C|C Whistleblower Lawyer Team Chemed, and its wholly-owned subsidiary, Vitas, have agreed to pay $75 million to resolve a government lawsuit brought under the False Claims Act (FCA). According to the DOJ’s press release, the settlement resolves allegations that between 2002 and 2013 Vitas submitted false claims to Medicare for services to hospice patients who were not terminally ill. The government’s...

In Their Own Words -- Readler

Posted  10/31/17

-- “Medicare’s hospice benefit provides critical services to some of the most vulnerable Medicare patients, and the Department will continue to ensure that this valuable benefit is used to assist those who need it, and not as an opportunity to line the pockets of those who seek to abuse it.”

Acting Assistant Attorney General Chad A. Readler commenting on the government’s $75 Million settlement with Chemed.

DOJ Intervenes in Whistleblower’s Suit Alleging Health Care Company Defrauded Medicare

Posted  10/18/17
By the C|C Whistleblower Lawyer Team The Justice Department announced a lawsuit Tuesday against the husband-and-wife owners of a health care company outside Chicago, alleging they violated the False Claims Act by falsely billing Medicare for millions of dollars in unnecessary or nonexistent home healthcare services. According to the lawsuit, the couple netted millions of dollars through the scheme. The...

DOJ Catch of The Week -- Foundations Health Solutions

Posted  07/21/17
By the C|C Whistleblower Lawyer Team This week's Department of Justice "Catch of the Week" goes to Foundations Health Solutions Inc., Olympia Therapy Inc. and Tridia Hospice Care Inc.  On Monday, these Ohio-based companies, comprising one of the largest nursing home operations in the state, and their executives Brian Colleran and Daniel Parker, agreed to pay roughly $19.5 million to resolve allegations that they...

Philadelphia Hospice Company to Pay $2M to Settle Whistleblower Case

Posted  07/7/17
By the C|C Whistleblower Lawyer Team A hospice company in Bensalem, Pennsylvania, has agreed to pay to the United States $2 million to resolve allegations that it provided unnecessary hospice services. Compassionate Care of Gwynedd Inc. is a hospice provider based in Bensalem and a subsidiary of Compassionate Care Hospice Group Inc., a Florida corporation with its principal place of business in Parsippany, New...

Mother and Daughter Owners of Home Health Agencies Each Sentenced to Over 10 Years in Prison for Roles in $20 Million Fraud Scheme

Posted  06/16/17
By the C|C Whistleblower Lawyer Team A mother and daughter who secretly co-owned and operated seven home health care agencies in the Miami, Florida area were each sentenced to over 10 years in prison for their roles in a $20 million Medicare fraud conspiracy that involved paying illegal health care kickbacks to patient recruiters and medical professionals. Mildrey Gonzalez, 61, and her daughter, Milka Alfaro,...

Hospice Companies Settle FCA Case for $12.2M

Posted  04/20/17
By the C|C Whistleblower Lawyer Team Several Hospice companies settled allegations they violated the False Claims Act (FCA) by paying kickbacks for patient referrals. The companies include Hospice Plus; Goodwin Hospice, LLC; Phoenix Hospice, LP; Hospice Plus, L.P.; and Curo Health Services, LLC. Mooresville, North Carolina-headquartered Curo Health Services operates eight hospice affiliates across 18 states. Curo...

Home Health Agency Owner Pleads Guilty to Conspiring in $17 Million Medicaid Fraud Scheme

Posted  03/31/17
By the C|C Whistleblower Lawyer Team The owner and operator of five Houston-area home health agencies pleaded guilty to conspiring to defraud Medicare and the State of Texas’s Medicaid-funded Home and Community-Based Service and Primary Home Care programs of more than $17 million.  He also pleaded guilty to conspiring to launder money.  These health care programs provided qualified individuals with in-home...