Washington D.C. – In a multi-million-dollar settlement, Tennessee-based home health care provider CareAll Management LLC and related entities have agreed to pay $9.375 million to resolve a False Claims Act lawsuit filed by the United States in 2009.
According to the Justice Department, the lawsuit alleged that James W. Carell, CareAll Management LLC (formerly known as Diversified Health Management Inc.), CareAll Inc., the James W. Carell Family Trust, VIP Home Nursing and Rehabilitation Services LLC, Professional Home Health Care LLC, University Home Health LLC, and Elizabeth Vining (as representative of the Estate of Robert Vining) fraudulently submitted eight cost reports for fiscal years 1999, 2000, and 2001 to support their Medicare billings.
The complaint alleged that these cost reports were false because they knowingly hid the relationship between the management company and the home health agencies. The relationship would have lowered the Medicare reimbursement for the management company’s services.
The United States further alleged in court filings that the management company exerted significant control over the home health agencies in a myriad of ways, including: James W. Carell’s key role in facilitating Robert Vining’s purchase of the home health agencies; loans worth millions of dollars from companies owned by James W. Carell to the home health agencies; cash transfers for millions of dollars from the management company to the home health agencies; the management company’s day-to-day control over the home health agencies’ operations; and Robert Vining’s role as a mere figurehead owner.
“The false reporting scheme alleged in this case robbed the Medicare Trust Fund of millions of taxpayer dollars,” said Stuart Delery, Acting Assistant Attorney General for the Civil Division of the Department of Justice. “Settlements like this one make sure that our federal health care dollars are spent appropriately – on maintaining critical health care programs.”
As part of the settlement, CareAll and its related entities have agreed to be bound by the terms of a Corporate Integrity Agreement with the Department of Health and Human Services – Office of Inspector General (HHS-OIG). The agreement requires the entities to implement various compliance measures to prevent future misconduct.
CareAll and its related entities are one of the largest home health providers in Tennessee. The settlement resolves the United States’ lawsuit alleging that the entities fraudulently submitted the cost reports to support their Medicare billings.
“This settlement is yet another example of this office’s commitment to enforcing the False Claims Act in health care cases and protecting the taxpayer’s interests,” said Jerry E. Martin, U.S. Attorney for the Middle District of Tennessee. “The U.S. Attorney’s Office will continue to vigorously pursue those who seek to defraud the federal government and undermine the integrity of our healthcare system.”
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