"As the name implies, home health services are reimbursed by Medicare only for patients who can't leave home without considerable effort." said whistleblower attorney Jim Barger.
Montgomery, Alabama (PRWEB) March 12, 2013
Home Health provider Techota, LLC -- which owns home health companies operating in rural Alabama -- has agreed to enter into a corporate integrity agreement with the Department of Health and Human Services and an ability-to-pay settlement, including reimbursement of attorneys' fees and costs, according to settlement documents filed in the U.S. Court for the Middle District of Alabama. The settlement resolves an almost two-year investigation into the company's business practices that began with a whistleblower lawsuit, United States ex rel. McDonald v. Techota, LLC, et al., 11-cv-00366, filed by Frohsin & Barger in May of 2011.
According to the original whistleblower Complaint, the lawsuit involved allegations that Techota and its subsidiaries Cahaba Valley Health Services and Cahaba Valley Home Health caused false claims to be submitted to Medicare for patients who were not home bound and did not require home care. Among the more egregious examples alleged in the complaint, was a patient who requested that the home health nurses visit him at his job because he was too busy to be home every time nurses came to provide treatment. "As the name implies, home health services are reimbursed by Medicare only for patients who can't leave home without considerable effort." said whistleblower attorney Jim Barger. "In other words, Medicare won't pay a company for home health services for someone who is down at the local auto parts store everyday."
Medicare regulations also require that home health patients require at least part-time skilled nursing care or therapy and be under an established plan of care periodically reviewed by a physician and the qualified home health company. Court documents paint a picture of wasted home health visits, alleging instances where nurses did little more than deliver cigarettes to people and sit with them watching television. "The allegations of waste and abuse settled in this lawsuit offer one explanation why our Medicare dollars are so rapidly deteriorating while the need for quality health care is rapidly expanding," said Henry Frohsin. "Frohsin & Barger commends United States Attorney George Beck, Assistant United States Attorney Jim DuBois, and Department of Justice trial attorney Natalie Priddy for tackling this case and bringing it to resolution."
According to the settlement documents, Techota will repay a portion of the alleged false claims pursuant to its ability to pay, reimburse attorneys' fees and costs, and implement safeguards to prevent future false claims. The settlement documents further provide that if Techota breaches the agreement it could be forced to forfeit any undisclosed assets and pay as much as $4.1 million plus penalties and interest.