Washington, DC – The Department of Justice recently announced that Atlantic Home Health Care LLC (AHH), a home health care agency operating in Arizona and eight other states, has agreed to pay $9,990,944 to resolve allegations that it violated the False Claims Act by submitting false claims to the Energy Employees Occupational Illness Compensation Program (EEOICP or the Energy Program), a healthcare program administered by the Department of Labor (DOL) for the benefit of Department of Energy employees and contractors with occupational illnesses. The settlement is based on AHH’s financial condition.
The United States alleged that, between 2017 and 2021, AHH falsely billed the Energy Program for in-home nursing and personal care when its employees were not physically present in patients’ homes. The government also alleged that AHH paid kickbacks, in the form of cash payments up to $5,000 for patient referrals via its “friends and family program” and in-kind payments for food, internet, travel and other expenses made to patients and their families. The Anti-Kickback Statute prohibits parties who participate in federal healthcare programs, such as the Energy Program, from knowingly and willfully paying or receiving any remuneration in return for referring an individual to, or arranging for the furnishing of, any item or services for which payment is made by, the federal healthcare programs. Prior to the United States’ disclosure to AHH of its investigation, AHH made a voluntary disclosure to the Department of Health and Human Services Office of Inspector General (DHS-OIG) concerning the company’s “friends and family” program and in-kind remuneration to patients and their families. In the settlement agreement, the United States acknowledged AHH’s cooperation in this regard.
“The department is committed to protecting the integrity of the Energy Employees Occupational Illness Compensation Program, a vitally important program that addresses the medical needs of vulnerable individuals who sustained injuries or illnesses while performing their official duties for the Department of Energy,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “We are dedicated to ensuring that program beneficiaries receive proper care and that taxpayer dollars are protected from waste, fraud and abuse.”
“Quality care is critical to beneficiaries participating in the Energy Employees Occupational Illness Compensation Program,” said U.S. Attorney Gary M. Restaino for the District of Arizona. “The payment of cash kickbacks to induce referrals has no place in our healthcare system. False Claims Act enforcement protects the integrity of federal healthcare programs.”
“The Office of Workers’ Compensation Programs (OWCP), which oversees the Energy Program within the Department of Labor, wishes to thank all involved in attaining this settlement,” said OWCP Director Christopher J. Godfrey. “With our committed partners at the Justice Department and within DOL’s Office of the Inspector General, we believe that we can continue to hold medical providers accountable for their actions when they take advantage of our claimants and program. That accountability will reduce future fraud, waste and abuse by other providers.”
The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by Tonya Cass, who was formerly employed as the Corporate Administrator and Director of Human Resource Administration and Management by AHH and its predecessor, Victory Medical Solutions, from September 2017 through January 2020. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The qui tam case is captioned U.S. ex rel. Cass v. Atlantic Home Health Care LLC, et al., No. CV-20-00202-TUC-AMM (D. Az.). As a part of the resolution with AHH, Cass will receive approximately $1.7 million.
The resolution obtained in this matter was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section and the U.S. Attorney’s Office for the District of Arizona.
The investigation and resolution of this matter illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to HHS at 800-HHS-TIPS (800-447-8477).
The matter was handled by Trial Attorney Allie Pang of the Civil Division’s Commercial Litigation Branch, Fraud Section and Assistant U.S. Attorney Anne Nelson for the District of Arizona, with the assistance of U.S. Attorney’s Office Auditor Connie Mudd, Civil Division Auditor John Ounsted and Financial Analyst Sheryl Paynter.
The claims resolved by the settlement are allegations only, and there has been no determination of liability.
Source: US DOJ