In what was by far the largest home health care settlement in the history of the False Claims Act, home health care provider Amedisys, Inc. (Amedisys) agreed in April 2014 to pay $150 million to resolve civil fraud liabilities under the federal False Claims Act and entered into a Corporate Integrity Agreement with the Office of HHS-OIG.
This settlement marked the successful conclusion of a lengthy effort by our client, relator CAF Partners (a partnership of individuals) to expose Amedisys’ fraudulent home health care practices. They alleged that Amedisys systematically manipulated data to make patients appear sicker than they actually were in order to justify extra, unnecessary therapy visits to qualify for bonus payments under the Medicare Home Health Prospective Payment System (PPS). Amedisys used its proprietary software system to seek not only, to admit, and subsequently recertify, patients to home health care that did not meet the Medicare guidelines for services, but also targeted patients for recertification in order to qualify for higher reimbursement from Medicare.
Amedisys paid $150 million to resolve these allegations and those raised by other whistleblowers.
We were assisted in this case by Kenney & McCafferty.