May 14, 2014 — Medicare exists to help people in need. Medicare fraud by unethical home health care providers just drives up health care costs for everyone. The U.S. Justice Department (DOJ) depends on courageous whistleblowers to notify the government about Medicare fraud by bringing a False Claims Act lawsuit. The statute’s qui tam language gives insider employees a way to do the right thing and be rewarded for it. Tipsters who file suit for the taxpayers’ benefit are eligible to receive a sizable share of any proceeds from the suit.
Settlement Resolves Seven Whistleblower Lawsuits Alleging Amedisys Made False Claims to Medicare for Ineligible Home Health Care Services and Patients
Amedisys Inc. — a Louisiana company providing home health services to patients in 37 states — has settled seven qui tam lawsuits making False Claims Act allegations. The health care provider and its affiliates will spend $150 million to resolve claims that Amedisys billed Medicare for patients and services ineligible under the federal healthcare program. The whistleblowers, most of whom are former employees with Amedisys, will share more than $26 million as their portion of the significant recovery.
From 2008 to 2010, alleged the DOJ, Amedisys management pressured therapists and nurses to keep their eyes fixed on company profits as opposed to patient care. Toward that end, Amedisys allegedly submitted claims to Medicare for therapy and nursing services provided to patients who were not confined to home or did not need the services. In addition, Amedisys misrepresented the condition of its patients to justify higher Medicare reimbursements.
Amedisys also was alleged to have improper financial relationships with referring doctors, in violation of the Anti-Kickback Statute and the Stark Statute, which govern the nature of permissible financial relationships between home healthcare providers and the physicians who refer patients to them. In particular, it was alleged that Amedisys employees performed patient care coordination services at discounted prices for an oncology practice in Georgia in exchange for the referral of oncology patients to Amedisys.
Health Care Insiders Stand Up to Fight Medicare Fraud
Health care insiders like the ones who worked at Amedisys are usually among the first to report False Claims Act violations. But most whistleblowers simply don’t know how to file their own qui tam lawsuit. With knowledgeable and experienced lawyers across the country, Waters & Kraus guides informants through the process, ensuring that their interests are taken care of. Email or call our False Claims Act attorneys at 855.784.0268 to learn how you can take a stand against health care fraudsters.