Home Health and Hospice

July 13, 2016

Minnesota-based provider of hospice care Evercare Hospice and Palliative Care agreed to pay $18 million to resolve charges it violated the False Claims Act by claiming Medicare reimbursement for hospice care for patients not eligible for such care because they were not terminally ill.  Specifically, the government alleged that Evercare’s business practices were designed to maximize the number of patients for whom it could bill Medicare without regard to whether the patients were eligible for and needed hospice.  The allegations originated in whistleblower lawsuits filed by former employees of Evercare under the qui tam provisions of the False Claims Act.  They will receive a yet-to-be-determined whistleblower award from the proceeds of the government’s recovery.  Whistleblower Insider

May 27, 2016

Partner Mary Inman was quoted in the Modern Healthcare article, Feds will appeal loss in Medicare fraud case over hospice eligibility.  Click here to read the article. 

May 6, 2016

The Trustees of the University of Pennsylvania, on behalf of its operating divisions, including the University of Pennsylvania Health System (UPHS), agreed to pay roughly $76,000 to settle charge of violating the False Claims for the alleged submission of false home health care billings to the Medicare program.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act.  DOJ (EDPA)

April 11, 2016

Naseem Minhas, the owner and operator of Detroit-area home health care agency TriCounty Home Care Services Inc. pleaded guilty today for his participation in a $4 million health care fraud scheme.  According to admissions made as part of his plea agreement, Minhas paid a physician and recruiters to refer Medicare beneficiaries to TriCounty and sign medical documents falsely certifying that they required home health care.  Minhas, a licensed physical therapist, also admitted that he assisted in creating fake patient files to make it appear as though the patients needed and received services that were unnecessary or not provided.  DOJ

April 4, 2016

Partner Mary Inman was quoted in the al.com article, Judge tosses out $200 million AseraCare hospice whistleblower lawsuit.  Click here to read the article.

March 31, 2016

Partner Mary Inman and Associate Ari Yampolsky were quoted in Modern Healthcare article, Hospice Provider AseraCare scores a win in unusual False Claims case.  Click here to read more.

March 18, 2016

A federal jury in New Orleans convicted Elaine Davis and Dr. Pramela Ganji for their roles in a $34 million Medicare fraud scheme.  The jury found that Davis, who owned Christian Home Health Care Inc., together with Ganji caused the healthcare company to bill Medicare for home health care services that were not needed and/or not actually provided.  Davis paid employees to recruit new patients and then sent their Medicare information to doctors, including Ganji, to obtain their signatures to certify that the patients qualified to receive home health care services, which trial evidence showed they did not qualify for or need.  DOJ

March 17, 2016

Carlos Medina, owner of Miami-area medical clinics Doral Community Clinic Inc. and Advanced Medical of Doral Inc. was sentenced to 82 months in prison for his role in a Medicare fraud scheme that caused more than $3 million in losses.  The clinics purportedly provided medically necessary services to Medicare beneficiaries, but in reality charged cash kickbacks in exchange for prescriptions for home health care services.  Some of the beneficiaries who frequented the clinics did not meet Medicare’s criteria for the prescribed services and some of the services prescribed by the medical professionals at Doral and Advanced Medical were never provided by the home health agencies to which the patients were referred.  DOJ

March 6, 2016

Whistleblower attorney Ari Yampolsky was quoted in the Pittsburg Post-Gazette article, Hospice fraud becoming a costly problem for Medicare.  Click here to read the article.