According to a press release from the Department of Justice, Care All Management LLC and its affiliates have agreed to pay $25 million plus interest to the United States and the State of Tennessee to resolve allegations that Care All violated the False Claims Act by submitting false healthcare billings to Medicare and Medicaid. This settlement resolves allegations that between 2006 and 2013, Care All overstated the severity of patients’ conditions to increase billings and billed for services that were not medically necessary.
According to Acting Assistant Attorney General, Joyce R Branda, “Home health agencies may only bill Medicare and Medicaid for care that is necessary and covered by the programs.” This is Care All’s second settlement of alleged False Claims Act violations within the last two years. In 2012, Care All paid nearly $9.38 Million for allegedly submitting false cost reports to Medicare.
This settlement illustrates the government’s emphasis on combating health care fraud, and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative.
The Tennessee False Claims Act can be found at Tennessee Code Annotated § 4-18-104, and this law provides that someone who violates the law may be ordered to pay up to three times the actual harm to the State of Tennessee, plus a fine equal to between $2,500 and $10,000 for each violation of the law.