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DOJ Catch of The Week -- Foundations Health Solutions

Posted  July 21, 2017

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 violated the False Claims Act by submitting to Medicare claims for medically unnecessary rehabilitation therapy and hospice services. See DOJ Press Release.

According to the government, Olympia and Provider Services Inc. (to which Foundations Health is the corporate successor) submitted claims to Medicare for medically unnecessary rehabilitation therapy services at 18 skilled nursing facilities. The government further claimed Tridia submitted claims to Medicare for hospice services to patients not eligible for the Medicare benefit because Tridia failed to conduct proper certifications or medical examinations.  Finally, the government alleged Colleran and Parker solicited and received kickbacks to refer patients from their skilled nursing facilities to home health care provider Amber Home Care LLC.

In announcing the settlement, the government stressed how important it is for health care providers to treat the welfare of their patients, particularly the elderly and most vulnerable, as their highest priority:

It is unacceptable for an entity entrusted to care for our most vulnerable and elderly citizens to make decisions based on profit, not quality of care. Subjecting the elderly to inappropriate levels of therapy can be physically harmful, and failing to properly certify and re-certify hospice patients can have a devastating impact on the patients and their families.

The government found the conduct at the center of this matter “not only violates provisions of the False Claims Act but the public’s trust,” and vowed “to aggressively investigate allegations of potential violations of this nature.”

The allegations originated in two whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by former Olympia employee Vladimir Trakhter and former Tridia employees Paula Bourne and La’Tasha Goodwin.  Mr. Trahkter will receive a whistleblower award of roughly $2.9 million and Ms. Bourne and Ms. Goodwin collectively will receive an award of roughly $740,000, all from the proceeds of the government’s recovery.

Tagged in: Anti-Kickback and Stark, Catch of the Week, FCA Federal, Home Health and Hospice, Lack of Medical Necessity, Whistleblower Rewards,