Cigna Urges Court to Drop Home Care False Claims Suit

Cigna Corp. has urged an Illinois federal court to drop a ‘flawed’ home care false claims suit, which accuses Addus HomeCare Corp. (NASDAQ: ADUS) and a Cigna subsidiary of bilking the government of millions of dollars by providing Medicare- and Medicaid-covered services to people who didn’t need them.

A complaint filed by Stop Illinois Marketing Fraud LLC shows no basis for holding the insurance company Cigna responsible for the alleged misconduct of subsidiary Home Physicians Group, which is supposed to have happened before Cigna bought the company, Cigna argued. Cigna joined and adopted the arguments raised by Addus in its motion to dismiss, Law360 reported.

Stop Illinois’ complaint has been amended once, and Cigna “appears to have been named as an afterthought,” the company stated.

“Although the complaint is premised on an arrangement in which Addus referred patients who were ineligible for home health care services to HPG and HPG certified them as eligible, it fails to identify a single patient who was certified despite being ineligible, fails to identify a single patient referred as part of the alleged arrangement and fails to identify a single false claim submitted to the government,” Cigna said.

The complaint alleges that Addus and Cigna made false claims to the government, and also created false documents. It goes on to accuse the two of conspiring to violate the False Claims Act.

Cigna disputed those claims, arguing that details or examples of false claims and documents weren’t provided by Stop Illinois. The insurance company also said the conspiracy allegation was unfounded, as Stop Illinois failed to include details of the conspiracy, such as what members of either company were involved.

From 2008 to 2013, Stop Illinois claims Addus “aggressively marketed” its home health care program to increase its worth and then sell it, according to Law360. Additionally, Addus attempted to convert patients who only needed unskilled services, like bathing and grooming, to those who needed skilled services, the complaint alleged.

Addus took in approximately $30.16 million from Medicare for skilled services in 2009, $32.63 million in 2010 and $33.44 million in 2011, Stop Illinois claimed, citing the company’s annual reports.

Most of Addus’ home health care services group was sold to LHC Group Inc. in February 2013. The company now focuses on providing home care.

Addus declined Home Health Care News’ request for comment Wednesday.

Written by Kourtney Liepelt