Medicare Whistleblower Receives Reward for Reporting Fraud by Allegiance Health Management
Allegiance Health Management, Inc. and four hospitals owned and operated by Allegiance have agreed to pay more than $1.7 million to resolve False Claim Act allegations. The Department of Justice (DOJ) announced on Tuesday, June 5, that the Louisiana-based post-acute healthcare management company’s settlement resolves a lawsuit filed under the whistleblower provision of the False Claims Act (FCA).
Ryan Ladner, who worked for Allegiance in Hattiesburg, Mississippi, originally filed the qui tam lawsuit and will receive $300,000 of the current settlement.
The FCA suit alleged that beginning in 2005, Allegiance coordinated with multiple hospitals across the Southeastern United States to provide Intensive Outpatient Psychotherapy (IOP) services to patients. At each of the outpatient centers, Allegiance allegedly provided services to Medicare beneficiaries that did not qualify for Medicare reimbursement.
“The Department of Justice recognizes the value of accessible mental healthcare, but will not tolerate companies that seek to exploit our most vulnerable populations by delivering inappropriate or worthless services,” Acting Assistant Attorney General Chad D. Readler said in the DOJ press release. “The Department of Justice is committed to holding accountable those who waste taxpayer dollars and place profit above the legitimate needs of patients.”
This settlement and over twenty prior settlements in this case were the result of a coordinated effort by the Civil Division of the Department of Justice, the United States Attorney’s Office for the Eastern District of Arkansas, and the Department of Health and Human Services, Office of Audit Services and Office of Inspector General.
The qui tam provisions of the FCA allow those with evidence of Medicare fraud to sue the wrongdoer on behalf of the United States government. In qui tam actions, the government has the right to intervene and join the action. The United States Government is required to compensate whistleblowers who initiate successful qui tam actions.
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