HealthCare Essentials' former CEO, CFO, pay to settle False Claims Act allegations

by Ben Vernia | January 10th, 2014

On January 10, the Department of Justice announced that the former Chief Executive and Chief Financial Officers of HealthCare Essentials had agreed to pay together more than $1 million to resolve whistleblowers’ claims that the two executives caused their now-bankrupt company to submit false claims for assisted living facility medical care. According to DOJ’s press release:

Michael R. Barr, former chief executive officer of Louisville, Kentucky-based HealthEssentials Solutions Inc., has agreed to pay $1 million to resolve allegations that he knowingly caused HealthEssentials to submit false claims to Medicare between 1999 and 2004, the Justice Department announced today. Norman J. Pfaadt, HealthEssentials’ former chief financial officer, also agreed to pay $20,000 to resolve similar allegations. H ea lt h E s s e nt i a ls p r o vi d ed p r i m a ry m e di c al c a re to p a ti e nts in nursing fa cilit ies, assisted living facilities and other settings from 1998 until it filed for bankruptcy and ceased operations in 2005. Barr founded HealthEssentials and served as its president, chief executive and board chairman. Pfaadt served as HealthEssentials’ senior vice president and chief financial officer.

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In March 2008, HealthEssentials pleaded guilty to submitting false statements to Medicare relating to services it provided to patients in assisted living facilities and entered into a civil settlement with the government. In May 2011, HealthEssentials’ former director of billing, Karen Stone, pleaded guilty for her role in the company’s billing scheme.

The settlement announced today resolves Barr’s and Pfaadt’s alleged liability under the False Claims Act for their roles in HealthEssentials’ false billings. The government alleged that, between 1999 and 2004, HealthEssentials billed for services that were inflated or not medically necessary and that Barr and Pfaadt pressured HealthEssentials employees to inflate the company’s billings, despite having been advised by attorneys and others that doing so would be improper. The government further alleged that Barr pressured HealthEssentials employees to conduct special medical assessments on patients, without regard to whether the patients required the assessments, solely to increase the amount that HealthEssentials could bill for the visits. As part of the settlement, Barr has agreed to a three-year period of exclusion from participating in federally funded health care programs.

The government disclosed that the two whistleblowers, former employees of the company, will receive $153,000 of the recovery (a 15% relator’s share).

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