Saad Healthcare, Medicare Fraud, Alabama 2023

Saad Healthcare, a Birmingham-based healthcare provider, has agreed to pay $3 million to settle allegations that it knowingly submitted false claims for the care of hospice patients in Alabama who were not terminally ill and therefore not eligible for the Medicare hospice benefit.

The settlement resolves allegations that between 2013 and 2020, Saad submitted, or caused the submission of, false claims to Medicare for 21 patients who did not meet the eligibility requirements for the Medicare hospice benefit, despite Saad knowing the patients were ineligible for the Medicare hospice benefit.

“Respectful and appropriate end-of-life care is the crux of the hospice benefit under Medicare,” said Principal Deputy Assistant Attorney General Brett A. Shumate of the Civil Division. “The government will hold accountable those who exploit this benefit for their own gain.”

The settlement was the result of a coordinated effort amongst the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section; the U.S. Attorney’s Office for the Southern District of Alabama; and the Department of Health and Human Services Office of Inspector General.

Assistant U.S. Attorney Nina Herring for the Southern District of Alabama and Trial Attorney Rory Skaggs of the Civil Division handled the matter.

Melissa Wolff and Whitney Sims, former Saad employees, filed a qui tam lawsuit under the False Claims Act, which permits private parties to file suit on behalf of the United States for false claims and share in a portion of the Government’s recovery. The two whistleblowers will receive $540,000 in connection with the settlement.

The investigation and resolution of this matter illustrate the government’s emphasis on combating healthcare fraud. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

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