Home health giant Amedisys Inc. (NASDAQ: AMED) has agreed to a $150 million settlement with the federal government for allegations that the company submitted false home healthcare billings to Medicare.
The national provider of home health care services allegedly improperly billed Medicare for ineligible patients and services including billing for services that were not medically necessary or for patients who were not homebound.
The $150 million sum also settles allegations that Ameidsys maintained improper financial relationships with referring physicians. According to all of the allegations, the company violated both the False Claims Act including the Anti-Kickback and Stark statues.
“It is critical that scarce Medicare home health dollars flow only to those who provide qualified services,” said Stuart F. Delery, Assistant Attorney General for the Civil Division in announcing the settlement. “This settlement demonstrates the department’s commitment to ensuring that home health providers, like other providers, comply with the rules and don’t misuse taxpayer dollars.”
The settlement resolves seven whistleblower lawsuits against Amedisys that were filed in federal courts both in Pennsylvania and Georgia. The whistleblowers, primarily former Amedisys employees, will receive a collective $26 million of the settlement, according to the Department of Justice.
Amedisys said it has disputed the allegations, but opted to settle the matter to avoid litigation and the costs involved.
“We are pleased to put this matter behind us,” said Ronald A. LaBorde, President and Interim Chief Executive Officer, in a press release. “We are intensely focused on achieving the best possible outcomes for our patients by providing the care they need, when they need it, in the comfort of their own homes. We strive diligently to ensure that our operations are fully compliant with Medicare program requirements.”
Amedisys has faltered in its financial performance this year and in March said it would close or consolidate 54 of its home care locations.
Written by Elizabeth Ecker