Whistleblowers Receive $9.67 Million for Blowing the Whistle on Fraud in Government Health Care Programs
On June 16, 2017, the Department of Justice announced that Genesis Healthcare, Inc. (Genesis) has agreed to pay the federal government $53639,288.04, including interest, to settle six lawsuits, brought by seven whistleblowers, that allege companies and facilities acquired by Genesis violated the False Claims Act (FCA).
The six lawsuits allege that the companies and facilities acquired by Genesis caused the submission of false claims to government health care programs for medically unnecessary therapy and hospice services, and grossly substandard nursing care. The four sets of allegations in the lawsuits include, billing for hospice services for patients who were not terminally ill, billing for more therapy minutes than the patients received, billing for outpatient therapy services that were not medically necessary, and billing for programs at certain of its nursing homes for services that were grossly substandard and/or worthless and therefore ineligible for payment.
“We will continue to hold health care providers accountable if they bill for unnecessary or substandard services or treatment,” said Acting Assistant Attorney General Chad A. Readler of the Justice Department’s Civil Division. “Today’s settlement demonstrates our unwavering commitment to protect federal health care programs against unscrupulous providers.”
“It’s disturbing when health care companies bill Medicare and Medicaid to care for vulnerable patients, but provide grossly substandard care and medically unnecessary services just to boost company profits,” said Special Agent in Charge Steven J. Ryan of the Department of Health and Human Services, Office of Inspector General (HHS-OIG). “We will continue to crack down on medical providers who betray the public’s trust and the needs of vulnerable patients through fraudulent billing and irresponsible practices.”
The whistleblowers, Joanne Cretney-Tsosie, Jennifer Deaton, Kimberley Green, Camaren Hampton, Teresa McAree, Terri West, and Brian Wilson, are former employees of companies acquired by Genesis. The qui tam provisions of the FCA permit private individuals to sue on behalf of the government for false claims for government funds and to receive a share of any recovery. The whistleblowers in these cases will receive a combined $9.67 million as their share of the recovery in this case.
Related Links:
- DOJ Press Release: Genesis Healthcare Inc. Settlement
- False Claims Act Whistleblower Resources
- Whistleblower Representation for False Claims Act Whistleblowers
