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Geriatric care provider will settle FCA suit for $117 million

By Qui Tam

HealthEssentials Solutions, Inc., a former Kentucky-based provider of geriatric care, has admitted to to submitting false claims to Medicare. The company has agreeed to criminal restitution of $3.1 million and payment of $117 million to resolve civil claims under the False Claims Act.

Three different whistleblower lawsuits filed by four former employees of the defendant company, alleged that HealthEssentials engaged in upcoding ? the practice of improperly assigning a billing code to a patient that is not supported by the medical record for the purpose of obtaining a higher level of reimbursement.

The March 28, 2008 press release from the U.S. Attorney's Office for the Westen District of Kentucky said that the company billed visits to patients in assisted living facilities as though they were performed in patients' homes.

On March 1, 2005, HealthEssentials filed for Chapter 11 bankruptcy protection.

Full post as published by False Claims Act - Qui Tam on April 08, 2008 (boomark / email).