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VNS Health: $1M Settlement for Failing To Provide Services to Hospice Patients

Posted  July 3, 2024

The U.S. Attorney’s Office for the Southern District of New York announced a substantial settlement with Visiting Nurse Service of New York (formerly VNSNY, now VNS Health) and its related entities. This settlement addresses allegations of fraudulent billing practices that undermined the Medicaid program meant to support some of the most vulnerable patients like those in hospice. 

VNS Health is one of the largest non-profit home and community-based health care organizations in the United States. They operate under a license from the New York State Office of Mental Health to provide Assertive Community Treatment (ACT) services. These services are essential for individuals with serious mental illness, offering comprehensive, community-based psychiatric treatment, rehabilitation, and support. However, according to the U.S. Attorney’s Office, VNS Health failed to deliver on its promises. 

From January 1, 2014, through December 31, 2018, VNS Health allegedly submitted false claims to Medicaid for services that were either not provided or not properly documented. This occurred at the VNS Far Rockaway ACT Program in Queens, where it is reported that 103 patients did not receive the full range of services that VNS Health was required to provide. 

Last week, U.S. District Judge Paul A. Engelmayer approved a settlement in which VNS Health will pay nearly $1 million in combined federal and state recoveries. Specifically, VNS will pay $381,766.59 to the United States and $572,649.89 to the State of New York. In addition to the financial settlement, VNS Health has admitted to and accepted responsibility for the conduct alleged in the U.S. Complaint. 

U.S. Attorney Damian Williams emphasized the critical nature of the services that were supposed to be provided: “The patients with serious mental illness who were receiving services from VNS’s Far Rockaway location deserved better. These individuals needed, and Medicaid agreed to pay for, a full suite of monthly support services so that they could better manage their disabilities. This Office will hold health care providers accountable when they fail to provide the necessary services that the federal and state governments are paying for.” 

The Complaint filed in Manhattan federal court outlined numerous deficiencies in VNS Health’s operations at the Far Rockaway ACT Program: 

  • Intake Forms and Initial Assessments: VNS Health often failed to complete or timely complete these crucial documents, which are necessary to record background information and set treatment baselines. 
  • Immediate Needs Assessments: These assessments, intended to evaluate patient needs for safety, food, clothing, shelter, and medical care, were frequently incomplete or delayed. 
  • Comprehensive Assessments: VNS Health neglected to conduct these assessments properly, which are vital for ongoing patient care. 
  • Service Plans: These plans, which outline the specific services needed to achieve patient recovery goals, were often missing or not updated in a timely manner. 
  • Psychiatric Visits: VNS Health failed to document numerous psychiatric visits, a fundamental component of the ACT program. 
  • Progress Notes: Essential for tracking patient progress, these notes were often recorded days or even weeks late, leading to improper billing for services. 

In 2020, Constantine Cannon represented a whistleblower in a False Claims Act case against VNS Health (then known as VNSNY). The allegations were that VNS Health failed to provide critical nursing and therapy visits as prescribed in patient Plans of Care. VNS Health agreed to pay $57 million to settle the case, marking the largest non-kickback False Claims Act settlement against a home health company. And yet, here they are again. 

In a positive light, this latest settlement with VNS Health is another one of the many significant steps taken, this year alone, toward maintaining justice in the healthcare system. It ensures that patients, and their families, are supported and deserve the trusted care they need. 

If you have information about potential healthcare fraud and would like to speak to an experienced Constantine Cannon whistleblower lawyer team member, please don’t hesitate to contact us for a free and confidential consultation.  

Tagged in: Healthcare Fraud, Home Health and Hospice, Medicaid, Medical Billing Fraud, Medicare,