The Department of Justice recently announced that A Plus Home Health Care, Inc., and its owners, have agreed to pay $1.65 million to the federal government to settle allegations of Home Health Fraud set forth in a whistleblower lawsuit under the civil False Claims Act. The whistleblower lawsuit alleged that the company compensated physicians to induce them to refer Medicare patients to A Plus’ Home Health Agency. Compensating physicians for the referral of Medicare patients is Home Health Fraud and violates the federal Anti-Kickback Statute. As compliance is a prerequisite to Medicare payment, claims tainted by an Anti-Kickback Statute violation that are subsequently submitted to Medicare for payment violate the civil False Claims Act.
The whistleblower lawsuit alleged that, beginning in 2006, A Plus paid spouses of referring physicians in return for Medicare referrals. Specifically, the whistleblower alleged that the Home Health Agency engaged in Home Health Fraud by providing the spouses of referring physicians with marketing position with A Plus. However, according to the whistleblower’s complaint, the marketing positions were a sham, requiring the spouses to do little, if any actual work. Instead, the salaries paid to the referring physicians were to induce physicians to refer their Medicare patients to A Plus’ Home Health Agency.
In fact, According to the home health whistleblower complaint, one of the owners of A Plus actually fired at least two spouses because their spouses did not refer enough patients to A Plus. And, according to the whistleblower complaint, this Home Health Fraud benefited A Plus’ owners greatly. For example, in 2010, one of the owners received a salary of $685,000 from A Plus when business increased due to increased Medicare referrals generated as a result of the unlawful Home Health kickbacks.
The settlement resolves allegations of Home Health Fraud that were originally brought by William Guthrie, a former director of development at A Plus, under the qui tam or whistleblower provisions of the False Claims Act, which permit private parties to sue on behalf of the United States for the submission of false claims and to receive a share of any recovery. The False Claims Act authorizes the United States to intervene in such lawsuits and take over primary responsibility for litigating them, as the United States did here. Guthrie’s whistleblower compensation share of this settlement has not yet been determined.
The whistleblower lawsuit is captioned United States ex rel. Guthrie v. A Plus Home Health Care, Inc., 12 CV 60629 (S.D. Fla.). The claims settled by the lawsuit are allegations only, and there has been no determination of liability.
No Fees Without Recovery
Ross M. Wolfe and the Weiser Law Firm litigate whistleblower lawsuits on a contingent fee basis, so whistleblowers do not pay attorneys’ fees or court costs unless there is a recovery.
Please contact Ross M. Wolfe if you would like to speak with a whistleblower attorney for more information about the whistleblower process, Home Health Fraud or to schedule a free consultation to confidentially discuss your potential case.