CareAll settles Tennessee whistleblower's case for $25 million, accepts extension of Corporate Integrity Agreement

by Ben Vernia | November 13th, 2014

On November 12, the Department of Justice announced that home health care company CareAll Management LLC had agreed to pay $25 million to settle civil allegations, originally brought by a qui tam relator, that the company submitted false claims for home health services. According to DOJ’s press release:

CareAll Management LLC and its affiliated entities (collectively “CareAll”) have agreed to pay $25 million, plus interest, to the United States and the state of Tennessee to resolve allegations that CareAll violated the False Claims Act by submitting false and upcoded home healthcare billings to the Medicare and Medicaid programs, the Department of Justice announced today. CareAll is based in Nashville, Tennessee, and is one of Tennessee’s largest home health providers.

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This settlement resolves allegations that between 2006 and 2013, CareAll overstated the severity of patients’ conditions to increase billings and billed for services that were not medically necessary and rendered to patients who were not homebound.

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This is CareAll’s second settlement of alleged False Claims Act violations within the last two years. In 2012, CareAll paid nearly $9.38 million for allegedly submitting false cost reports to Medicare. As part of the settlement announced today, the companies agreed to be bound by the terms of an enhanced and extended corporate integrity agreement with the Department of Health and Human Services-Office of Inspector General (HHS-OIG) in an effort to avoid future fraud and compliance failures.

DOJ announced that the relator will receive $3.9 million of the settlement (a 15.6% relator’s share).

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