INDIANAPOLIS - American Senior Communities, L.L.C. has agreed to pay over $5.5 million to resolve allegations that it violated the False Claims Act by submitting false claims to the Medicare program.
The company has locations throughout Indiana, including facilities in Terre Haute, Clinton, and Washington.
According to the United States Attorney’s Office Southern District of Indiana, in 2017, a former employee of a hospice services company working with American Senior Communities, L.L.C. (ASC) filed a “whistleblower” lawsuit under the False Claims Act. The complaint alleged that ASC was charging Medicare for therapy services provided to hospice patients, when those services should have already been covered by the patients' Medicare hospice coverage.
The estimated loss to the Medicare program was $2,795,522.33. ASC has agreed to pay $5,591,044.66 to the United States.
Under the False Claims Act, provides that when a whistleblower files a lawsuit alleging fraud that results in a recovery of funds by the Government they are entitled to between 15 and 25% of the recovery. This whistleblower provision of the law encourages people to come forward when they believe fraud is being committed. Under the False Claims Act, the Government may collect up to three times the loss it incurred, plus a fine of between approximately $5,500 to $22,000 for each false bill submitted.
“Whistleblowers are critical to protecting public funds from fraud, waste, and abuse,” said U.S. Attorney Zachary A. Myers. “Health care providers who submit false claims or otherwise violate state and federal regulations when billing the United States Government will face consequences. Today’s settlement demonstrates that federal law enforcement agencies will vigorously investigate reports of false claims and seek to recover funds on behalf of the public.”
“Health care providers that submit inappropriate claims to Medicare to boost their own profits compromise the integrity of this important federal health care program,” said Special Agent in Charge Mario M. Pinto of the U.S. Department of Health and Human Services Office of Inspector General. “We will continue to work tirelessly, alongside our law enforcement partners, to ensure the appropriate use of taxpayer dollars and hold those who violate the law accountable.”
In agreeing to the settlement terms, ASC denied all liability under the False Claims Act. In investigating the case, HHS-OIG did not uncover any evidence of injury or harm to patients because of the alleged conduct.
