The Department of Justice announced today that the United States and the state of New York have entered into settlement agreements with three home health agencies to resolve allegations that they submitted false claims to the New York Medicaid and Medicare programs.
The New York Medicaid program provides coverage for home health aides only if those aides have valid certificates showing that they received proper training. The United States contended that Nursing Personnel Home Care (Nursing Personnel) knowingly supplied aides with phony training certificates to Extended Home Care (Extended) and Excellent Home Care (Excellent), which then billed New York Medicaid for the aides' services; that Extended and Excellent knowingly billed for aides with phony certificates who were untrained; and that Extended and Excellent knowingly submitted claims to the Medicare program for home health aide services purportedly rendered by aides supplied by Nursing Personnel that were not actually provided. The United States is receiving approximately $9.7 million as a result of the settlement with these three companies, and the state of New York is receiving approximately $14.3 million, for a total recovery of $24 million.
"Our nation's Medicare and Medicaid patients deserve nothing less than quality health care they can depend on," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. "When home health agencies cut corners to avoid compliance with legal training standards, they seriously undermine the integrity of the care they provide." Assistant Attorney General West thanked the cooperative efforts of the Commercial Litigation Branch of the Civil Division, the U.S. Attorney's Office for the Eastern District of New York, the Office of Investigations for the Department of Health and Human Services' Office of Inspector General, the Medicaid Fraud Control Unit of the New York Attorney General's Office, and the New York State Office of the Medicaid Inspector General in achieving this settlement.
New York Attorney General Andrew M. Cuomo said, "The size of this settlement underscores the seriousness of the allegations and the importance of vigorous oversight of the Medicaid program and the medical care of our loved ones. Being treated at home is an important option for many New Yorkers, and the companies that provide this service at taxpayer expense have an obligation to ensure that the health care workers they employ are qualified for the job."
"This settlement reflects this office's commitment to investigate allegations of fraud committed on the Medicare or Medicaid programs, especially when the alleged fraud could impact the standard of care received by New Yorkers in need of medical assistance," said Benton J. Campbell, U.S. Attorney for the Eastern District of New York. Mr. Campbell praised the collaborative efforts of the state and federal agencies that contributed to the recovery of funds for the Medicaid and Medicare programs.
The allegations resolved by today's settlements were initiated by two lawsuits filed under the whistleblower provisions of the False Claims Act, which allow private citizens to file suit on behalf of the United States for fraud and share in any recovery. Maurice Keshner will receive $251,107 from the government's recovery from Nursing Personnel. Deborah Yannicelli will receive $1,663,040 from the government's recovery from Extended and Excellent.
The lawsuits were captioned as United States ex rel. Keshner v Nursing Personnel Home Care, et al., Civil Action No. 06-1067 (E.D.N.Y.), and United States and the State of New York ex rel. Jane Doe v. Extended Nursing Personnel CHHA, LLC, et al., Civil Action No. 07-4621 (E.D.N.Y.).
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