In The News

Amedisys Home Health Companies Agree to Pay $150 Million to Resolve False Claims Act Allegations

With so many Medicare fraud cases in the news regularly, it isn’t unheard of for us to let some slip by without sharing them with you…

Last year, Amedisys Inc. and its affiliates agreed to pay $150 million to the federal government to provide resolution to allegations that they infringed upon the False Claims Act by submitting dishonest home healthcare bills to the Medicare program. Amedisys is one of the largest providers of home health services in the United States, operating in 37 states, in addition to Columbia and Puerto Rico.

The settlement resolved the allegations that, from 2008 to 2010, particular Amedisys offices inappropriately billed Medicare for ineligible patients and services. This included billings for nursing and therapy services that were not considered medically necessary, some were provided to patients who weren’t homebound, and furthermore Amedisys misrepresented the conditions of patients’ in order to increase its Medicare payments. These violations were the alleged consequence of management pressure on nurses and therapists to deliver care based on the financial benefits to Amedisys as opposed to the needs of the patients. Allegations further assert that Amedisys maintained inappropriate financial relationships with referring physicians thus violating statutory requirements.

The false claims allegedly made by Amedisys deprive American taxpayers of millions of dollars, when these dollars could have been spent on care and treatment that is legitimately needed. Along with the settlement, Amedisys also agreed to follow the terms of a Corporate Integrity Agreement with the Department of Health and Human Services; these compliance measures are intended to circumvent and detect illicit conduct such as that alleged in this case.

This settlement provides resolution to seven lawsuits against Amedisys that were filed under the qui tam whistleblower provisions of the False Claims Act; these provisions allow citizens to make civil actions on behalf of the Federal Government. A Medicare fraud whistleblower is entitled to share in any recovery of funds. The whistleblowers against Amedisys, who are the primarily former employees, will collectively split over $26 million in whistleblower rewards.