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Healthcare Fraud: $2.5 Million False Claims Act Settlement for Home Health Companies
In a major blow to healthcare providers, Louisiana-based home health companies, Health Care Options, Inc. and Health Care Options of Lafayette, Inc., and Texas-based Home Care Options Houston, Inc. have agreed to settle a civil fraud complaint filed under the federal False Claims Act, paying $2.5 million to the United States.
According to U.S. Attorney Brandon J. Fremin, the defendants defrauded the Medicare and Louisiana Medicaid programs by submitting false and fraudulent claims for payment for home health services without required face-to-face encounters between patients and physicians between 2011 and 2018.
“The United States expects companies and individuals serving Medicare and Medicaid beneficiaries, including people in need of home health care, to fully comply with all requirements of those programs,” said U.S. Attorney Fremin. “This case highlights our commitment to aggressively pursue anyone trying to avoid their obligations to the Government and to health care patients. I want to thank our Assistant U.S. Attorney and our partners at HHS-OIG and the Louisiana Attorney General’s Medicaid Fraud Control Unit for their outstanding efforts in achieving this result.”
The settlement resolves a lawsuit, United States ex rel. Melanie Berzas v. Health Care Options, Inc., et al., No. 14-199-JWD-RLB, filed under the whistleblower provisions of the False Claims Act, which permits private parties to file suit on behalf of the United States and to share in a portion of the Government’s recovery.
U.S. District Judge John W. deGravelles has issued an order accepting the parties’ settlement agreement and has entered a consent judgment in favor of the United States. The settlement was investigated by the U.S. Attorney’s Office for the Middle District of Louisiana and the U.S. Department of Health and Human Services, Office of Inspector General, with substantial assistance from the Louisiana Department of Justice Medicaid Fraud Control Unit.
The United States was represented by Assistant United States Attorney Chase E. Zachary, a member of the Affirmative Civil Enforcement (ACE) unit in the U.S. Attorney’s Office. The ACE unit is responsible for filing civil lawsuits on behalf of the United States to recover government money lost to fraud or other misconduct and to impose civil penalties for violations of federal health, safety, and environmental laws.
Under the terms of the settlement, Howard D. Austin, II, a defendant in the case, has also agreed to pay a portion of the $2.5 million settlement.
The settlement marks a significant victory for the U.S. government in its efforts to combat healthcare fraud and protect vulnerable populations.
As U.S. Attorney Fremin stated, “This case highlights our commitment to aggressively pursue anyone trying to avoid their obligations to the Government and to health care patients.”
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Key Facts
- State: Louisiana
- Category: Healthcare Fraud
- Source: DOJ Press Release â†â€â€
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