The United States Department of Justice announced December 17, 2009 that the U.S. and state of New York have entered into settlement agreements with three home health agencies to resolve allegations that they submitted false claims to the New York Medicaid and Medicare programs.
The U.S. contends that Nursing Personnel Home Care knowingly supplied aides with phony training certificates to Extended Home Care and Excellent Home Care, which then billed New York Medicaid for the aides’ services. Allegedly, Extended Home Care and Excellent Home Care knowingly billed for aides with phony certificates who were untrained, and Extended Home Care and Excellent Home Care knowingly submitted claims to the Medicare program for home health aide services purportedly rendered by aides supplied by Nursing Personnel Home Care that were not actually provided.
The U.S. is receiving about $9.7 million as a result of the settlement with these three companies, and the state of New York is receiving about $14.3 million, for a total recovery of $24 million.
The allegations resolved by these settlements were initiated by two lawsuits filed under the whistleblower provisions of the False Claims Act.
For the full press release, go to: http://www.justice.gov/opa/pr/2009/December/09-civ-1362.html.
For more information about qui tam law and health care fraud, contact Nolan and Auerbach, PA.
On November 30, the US Supreme Court heard oral argument in Graham County Soil & Water Conservation District v. United States ex rel. Wilson, No. 08-304 (“Graham County II”), concerning the “public disclosure” provision in Section 3730(e)(4)(A) of the False Claims Act. The public disclosure provision and the “original source” provision of the False Claims Act is intended to define the statutory bar against copycat whistleblowers who merely repeat what they have read or heard in public arenas, without having first-hand information of such information. The issue in Graham County was whether fraud publicly disclosed in a state (as opposed to a federal) administrative investigation or audit report are “publicly disclosed” for purposes of the FCA. Counsel for the Relator and for the the Government (from the Solicitor General’s Office) urged the Court to restrict the term “administrative to federal sources because of a “likelihood” that Congress believed that federal authorities would focus upon strictly federal sources. At oral argument, it seemed that the Justices were of the opinion that the statutory language was far from clear, and that the legislative history on the specific phrase is non-existent. Therefore it may be that the issue will be decided upon policy grounds taking into account the purposes of the False Claims Act as intended by its drafters.
For more information about qui tam law and health care fraud, contact Nolan and Auerbach, PA .