The U.S. Department of Justice has joined a group of suits filed against HealthEssentials Solutions, a provider of geriatric services to nursing homes, assisted living facilities and home-based patients, has been charged with making false Medicare claims. The suits accuse HealthEssentials of upcoding Medicare billings and charging Medicare for needless services. Specifically, the charges say that HES not only upcoded care charges, but also billed for assisted living care for services actually provided in patients' homes.
These suits were initiated by former staffers from the Louisville, KY firm under whistleblower provisions of the False Claims Act. The False Claims Act allows whistleblowers to get a portion of any funds recovered by suits they file. The U.S. can charge HealthEssentials up to three times the amount of any payments which were fraudulently billed.
To find out more about the suits:
- read this United Press International piece [1]
- read the DOJ press release [2]
Related Articles:
Gov't: Pharmaco bilked CMS out of $500M. Report [3]
DOJ wants data on device payments. Report [4]
Links:
[1] http://www.upi.com/Health_Business/Briefing/2007/04/26/feds_join_healthessentials_fraud_suit/
[2] http://www.usdoj.gov/opa/pr/2007/April/07_civ_294.html
[3] http://www.fiercehealthcare.com/story/gov-t-pharmaco-bilked-cms-out-of-500m/2007-01-30
[4] http://www.fiercehealthcare.com/story/doj-wants-data-on-device-payments/2005-10-26