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Press Round-Up: Settlement in Visiting Nurse Service of New York Case Described as Groundbreaking

Posted  July 2, 2020

The record-setting $57 million settlement in U.S. ex rel. Lacey v. Visiting Nurse Service of New York, a False Claims Act case brought by Constantine Cannon client Edward Lacey, received extensive coverage in the media, with stories noting that the wrongdoing alleged was “pervasive” in the home health industry.

As a whistleblower, Lacey alleged that home health agency VNSNY failed to adhere to the plans of care physicians provided when they referred patients, and therefore failed to provide patients with all of the nursing, therapy, and other services in those plans of care.  Despite this, however, VNSNY sought reimbursement from Medicare and Medicaid as if it had provided all services in the plan of care, going so far as to falsify timesheets for visiting nurses.  In part, Lacey alleged, this occurred because VNSNY took on new patients without regard to its capacity to provide care to those patients.

In Politico’s article, Visiting nurse group agrees to $57M settlement in whistleblower suit, Constantine Cannon attorney Gordon Schnell described the alleged wrongdoing as “a pervasive process.  There’s nothing unique about what we allege VNS did that’s New York-focused or VNS-focused. It’s the environment for home health care.”  As noted in the article, the VNSNY settlement is the first FCA settlement to address failures by home health agencies to adhere to plans of care.

In industry press, Home Health Care News wrote that “the settlement shines a new light on common home health industry operating practices that some view as fraudulent or dangerous,” quoting Constantine Cannon attorney Dan Vitelli that the settlement has “the potential to reverberate throughout the home health industry.”

Modern Healthcare noted that the settlement was “the second-largest ever paid by a home care agency and the largest paid by a not-for-profit home care agency.”  Constantine Cannon attorney Marlene Koury described the practice of home health agencies adjusting plans of care without notifying physicians as “widespread,” stating that while the settlement was “the first case of its kind,” it was going to “send shock waves through the home health care industry.”

Law360 (subscription required), in its article Home Health Care Nonprofit To Pay $57M In Record FCA Deal described the settlement as part of “growing trend of government scrutiny of health care providers and nursing homes for potential FCA liability.”

Additional coverage can be found in Bloomberg Law and Crain’s New York Business.

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Tagged in: CC Lawyers, FCA Federal, Healthcare Fraud, Home Health and Hospice, Medical Billing Fraud, Whistleblower Case,