Home Health and Hospice Archives - Page 2 of 24

August 10, 2022

American Senior Communities, L.L.C., will pay over $5.5 million for violating the False Claims Act by charging Medicare directly for hospice services that should have already been covered by the beneficiaries’ Medicare hospice coverage. The fraudulent billing practice was exposed in a whistleblower complaint filed by a former employee of a hospice services provider that worked with ASC. The whistleblower is entitled to receive between 15 and 25% of the recovery. USAO SDIN

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, SNF, Whistleblower Rewards,

May 5, 2022

SHC Home Health Services of Florida, LLC, a/k/a Signature HomeNow paid $2.1 million for False Claims Act violations. Between 2013 and 2017, Signature HomeNow submitted false Medicare claims for home health services to patients who either were not homebound, did not require certain skilled care, did not have a valid or appropriate plan of care in place, and/or didn’t have the requisite face-to-face encounters for appropriate certification. USAO WDKY; USAO SDFL

Tagged in: FCA Federal, Home Health and Hospice, Medicare, Provider Fraud,

March 25, 2022

Two New York-based home health agencies, All American Homecare Agency and Crown of Life Care NY LLC, have agreed to pay a total of $5.4 million to settle allegations of violating federal and state False Claims Acts. The agencies had allegedly paid their home health aides below minimum wage, despite claiming otherwise and receiving millions for said wages from Medicaid. In addition to the monetary penalties, the agencies will also pay back wages owed to current and former aides. NY AG; USAO EDNY

Tagged in: FCA Federal, FCA State, Healthcare Fraud, Home Health and Hospice,

February 18, 2022

Muhammad Ateeq, of Rawalpindi, Pakistan, was sentenced to 12 years in prison and ordered to pay more than $50 million in restitution for forfeiture for submitting fraudulent claims to Medicare for home health services. Ateeq acquired and managed home health agencies in the United States, using false identities. He then used these home health agencies to submit fraudulent Medicare claims totaling over $40 million for services not rendered. The ill-gotten gains were laundered through U.S. bank accounts designated by overseas customers of overseas money transmitting businesses. Cash payments were then transmitted to accounts in Pakistan which Ateeq controlled. Fraud proceeds were also used to purchase luxury items which were delivered to Ateeq’s Dubai associates. DOJ

Tagged in: Criminal Proceedings, Healthcare Fraud, Home Health and Hospice, Medical Billing Fraud,

Catch of the Week: Texas Hospice CEO Gets 13 Year Sentence in $60 Million Fraud Scheme

Posted 01/28/22

A federal judge in Texas sentenced Bradley Harris, former head of Novus Health Services, Inc. hospice company in Frisco, to more than thirteen years in prison and ordered him to pay $27.6 million in restitution. The sentence, announced in a DOJ press release, follows his guilty plea on charges of conspiracy and fraud on Medicare and Medicaid. Harris is the latest to be sentenced in a fraud scheme spanning...

Tagged in: Catch of the Week, Government Programs Fraud, Healthcare Fraud, Home Health and Hospice, Improper Medical Facility, Improper Medical Personnel, Lack of Medical Necessity, Medicaid, Medicare,

Top Ten Financial and Healthcare Fraud Prison Sentences of 2021

Posted 01/28/22

Individuals involved in financial and healthcare fraud schemes face not just civil liability, but also criminal penalties – including prison time. In 2021, the Department of Justice obtained substantial prison sentences in a myriad of cases involving healthcare and financial frauds, many of which involved convictions of the type of fraudulent schemes that whistleblowers report. Whistleblowers play an essential role...

Tagged in: Compounding Pharmacy Fraud, COVID-19, Criminal Proceedings, Education Fraud, Financial and Investment Fraud, Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity, Medicare, Money Laundering, Ponzi Schemes, Securities Fraud, Top 10,

December 1, 2021

A collection of hospices known as Crossroads Hospice has agreed to pay $5.5 million to settle allegations raised in two qui tam suits by former employees Leanne Malone, Jackie Burns, and Angela Heck, and a home health physician in Tennessee, Dr. David Weber. In their lawsuits, the whistleblowers alleged that between 2012 and 2014, Crossroads billed Medicare for hospice care for patients who were not terminally ill, including patients with Alzheimer’s or dementia. Malone, Burns, and Heck will divide a million-dollar relator’s share. USAO WDTN

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Whistleblower Case, Whistleblower Rewards,

November 23, 2021

A number of related entities operating in Ohio and Tennessee as Crossroads Hospice have agreed to pay $5.5 million to resolve allegations that they submitted false claims for hospice services that were not covered by Medicare. Specifically, the government alleged that over a period of three years, Crossroads submitted claims for dementia or Alzheimer’s patients who were not terminally ill for at least a portion of the more than three years that the patients received care. Two qui tam actions were filed regarding the false claims; the three individuals who jointly filed the first action, Leanne Malone, Jackie Burns and Angela Heck, were previously employees of Crossroads, and will receive approximately $1.045 million. DOJ

Tagged in: Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity, Medical Billing Fraud, Whistleblower Case, Whistleblower Rewards,

November 22, 2021

Home health provider PruittHealth, Inc. has agreed to pay $4.2 million to resolve allegations that they knowingly submitted false claims for services that were not eligible for reimbursement because, among other things, they did not have the required face-to-face certifications or plans of care, and they did not document the beneficiary’s homebound status or need for the home health services. Tina Peery, who initiated the government action by filing a qui tam complaint, will receive an award of $700,000. USAO ND Ga

Tagged in: FCA Federal, Healthcare Fraud, Home Health and Hospice, Lack of Medical Necessity, Whistleblower Case, Whistleblower Rewards,

November 1, 2021

Geisinger Community Health Services, based in Pennsylvania, has agreed to pay over $18.5 million to resolve its liability following a self-disclosure of violations of the False Claims Act. The violations occurred between 2012 and 2017 and involved physician certifications of terminal illness, patient elections of hospice care, and physician face-to-face encounters with home health patients. USAO MDPA

Tagged in: Certifications, FCA Federal, Healthcare Fraud, Home Health and Hospice, Medicare, Provider Fraud,

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