Amedisys home health care companies will pay $150 million to settle claims of seven whistleblower lawsuits for healthcare fraud filed under the False Claims Act in federal courts alleging fraudulent home healthcare billings to Medicare and improper financial relationships with physician groups.
Whistleblowers Included April Brown, Natalie Raven, and Others
Amedisys whistleblowers listed on the seven False Claims Act complaint captions as relators included April Brown, CAF Partners, Umberhandt, Ognen, Lewis, and Natalie Raven. The lawsuits were filed under the False Claims Act terms allowing citizens to file whistleblower suits on behalf of the U.S. and share in any money recovered.
Home healthcare worker April Brown, a nurse from the Monroeville, Alabama area, knew something wasn't right when her employer, Amedisys, asked her to bill Medicare for services that she had not been providing and for work that had not been “medically necessary”.
When she brought these concerns to her supervisors, Brown likely anticipated a concerned, ethical and urgent response. What happened instead -- the company fired her from her job -- shocked her and precipitated one of the seven legal actions that ended in today’s $150 million settlement and whistleblower April Brown splitting a $26 million whistleblower reward with the other Amedisys whistleblowers.
Amedisys Settles Healthcare Fraud & Kickback Allegations
Amedisys Inc., a Louisiana-based hospice and home health care provider, by this settlement resolves several sets of healthcare fraud allegations brought to light by the False Claims Act whistleblower lawsuits including:
Allegations that Amedisys violated the Anti-Kickback Statute and the Stark Statute that limit the financial relationships between healthcare providers and referring physicians. Contentions that the company fraudulently billed Medicare for providing home healthcare services to patients who were not homebound and otherwise pressured therapists and nurses to make medical and billing decisions based on profit rather than medical needs of patients.
“Significant Recovery of Public Funds” says U.S. Attorney
“Amedisys made false Medicare claims, depriving the American taxpayer of millions of dollars and unlawfully enriching Amedisys,” said a U.S. Attorney for the Northern District of Alabama, Joyce Vance who credited the work of her North Georgia, Eastern Pennsylvania, Eastern Kentucky U.S. attorney colleagues, and the U.S. Justice Department’s Civil Division for the $150 million settlement.
“This settlement represents a significant recovery of public funds and an important victory for taxpayers,” echoed Kerry Harvey, Eastern District of Kentucky U.S. Attorney.
The seven whistleblower lawsuits were filed in the Northern District of Georgia and the Eastern District of Pennsylvania. A Department of Justice statement explained that the $150 million settlement is not based on any judicial finding of liability or admission of guilt by Amedisys, Inc.