La. based health companies to pay $150M for Medicare fraud

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Thursday, April 24, 2014 - 3:11pm

The Department of Justice announced on Tuesday that the Louisiana based company Amedisys Inc. and it affiliates have agreed to pay the federal government $150 million after allegations that they submitted false home-healthcare billings to the Medicare program, which is a violation of the False Claims Act.

Amedisys is one of the nation’s largest providers of home health services and operates in 37 states, the District of Columbia and Puerto Rico.

“It is critical that scarce Medicare home health dollars flow only to those who provide qualified services,” said Stuart F. Delery, Assistant Attorney General for the Civil Division. “This settlement demonstrates the department’s commitment to ensuring that home health providers, like other providers, comply with the rules and don’t misuse taxpayer dollars.”

Certain Amedisys offices were accused of billing Medicare between 2008 and 2010 for patients and services that did not qualify for Medicare funds.

The offices allegedly billed Medicare for medically unnecessary services and misrepresented patients’ conditions to increase payments.

Allegedly, these violations resulted from management pressure on caregivers to provide services based on the financial benefit to the company rather than patient needs.

Amedisys also agreed to a Corporate Integrity Agreement that requires the company to use compliance measures meant to avoid or detect similar misconduct.

“Improper financial relationships and false billing, as alleged in this case, can shortchange taxpayers and patients,” said Daniel R. Levinson, Inspector General for the U.S. Department of Health and Human Services. “Our compliance agreement with Amedisys contains strong monitoring and reporting provisions to help ensure that people in Federal health programs will be protected.”

This settlement resolves seven lawsuits pending against Amedisys in federal court, six in Pennsylvania and one in Georgia.

As part of Wdnesday’s settlement, the whistleblowers (primarily former Amedisys employees) will collectively split more than $26 million.

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