Benslem PA Hospice Settles Whistleblower Suit for $2 Million

By a News Reporter-Staff News Editor at Insurance Weekly News -- On July 6, 2017, US District Judge Robert B. Kugler ordered the unsealing of the complaint and settlement agreement in a whistleblower lawsuit against Compassionate Care Hospice Bensalem (PA), a subsidiary of Florida-based Compassionate Care Hospice Group, Inc., New York City attorney Timothy J. McInnis, of McInnis Law, announced. Under the terms of the agreement with two ex-employees and the United States, CCH will pay $1,987,500 to the government to resolve Medicare fraud allegations in the lawsuit captioned United States, et al., ex rel. Jane Doe and Mary Roe v. Compassionate Care Hospice, et al., Civil Action No. 10-3484 (D.N.J.). CCH will also pay the whistleblowers $600,000 to resolve retaliation claims and attorneys' fees.

According the complaint, CCH billed Medicare for services that were not rendered, not medically necessary, or obtained through kickbacks, in violation of the False Claims Act. The complaint details instances where CCH billed Medicare for hospice services for patients who did not meet the requirements for terminal illness or who did not need higher levels of hospice care. The whistleblowers also charged that CCH violated the anti-retaliation provisions of the False Claims Act and New Jersey's Conscientious Employee Protection Act by firing one employee after she objected to the company's fraudulent billing practices and by creating a work environment that forced the other to quit.

The whistleblowers (called "relators" in the lawsuit), were represented by attorneys McInnis and Britton Monts of Austin, Texas based Monts Law. McInnis stressed the need to bring cases like this to light. "Hospice fraud exploits our most vulnerable members of society at the expense of U.S. taxpayers. It is vital for employees of healthcare organizations to speak up if they suspect Medicare or Medicaid billing fraud." McInnis further noted that the government encourages people to come forward by rewarding them for their information, typically 15% to 25% of any proceeds. In this case, the settlement agreement provides for the whistleblowers to share approximately $360,000 (18%) of the government's recovery.

Passed by President Lincoln in 1863, the False Claims Act is the most effective tool for rooting out fraud against government programs, McInnis explained. Under its "qui tam" provisions citizens can sue wrongdoers on behalf of the government. In this case, however, the government chose to take over the case after investigating the whistleblowers' allegations, McInnis said.

For additional information, contact attorney Timothy McInnis at (212) 292-4573.

Keywords for this news article include: Medicare, McInnis Law, Legal Issues, Health Policy.

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