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Home Health Company Settles Medicare Fraud Case Brought by Whistleblower for $150 Million

Amedisys, a home heath company that operates in over three dozen states, has agreed to pay $150 million to resolve Medicare Fraud claims brought by a former employee. According to a whistleblower lawsuit, between 2008 and 2010, a number of the company’s offices improperly billed Medicare.

April Brown, a nurse, said Amedisys violated the False Claims Act when it turned in false home healthcare billings to Medicare. She says that the company asked her to bill for services that were not necessary or were never actually provided. She also worked with patients who weren’t actually homebound. Brown and other nurses were purportedly pressured into providing care that benefited the home health care’s financial needs instead of the health needs of patients.

Brown contends that when she questioned what was going on, she was let go from her job. She then became the first person to file a qui tam case against Amedisys. Several other individuals followed and their respective cases were consolidated in federal court.

The whistleblower case was resolved with the U.S. Justice Department. Because the False Claims Act allows whistleblowers to receive a percentage of recovery-in this case that amount is $26 million-the money will be distributed among the whistleblowers. Because Brown was the first whistleblower, she will get $15 million.

The lawsuit also resolves allegations that Amedisys kept up improper financial relationships with referring doctors. The government contends that the company’s financial relationship with one private oncology practice violated the requirements of the Anti-Kickback Statute and the Stark Statute.

Whistleblower Cases
If you are aware that the government is being defrauded you may be able to file a whistleblower case. As the whistleblower, you could be entitled to part of the recovery. In Massachusetts, you should work with a Boston Medicare fraud lawyer who is experienced in handling Qui Tam cases and can protect your rights. Your attorney can also make you receive your share of what the state or federal government gets back as a result of your lawsuit.

Amedisys Home Health Companies Agree to Pay $150 Million to Resolve False Claims Act Allegations, DOJ, April 23, 2014

The False Claims Act (PDF)

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