The Justice Department has, according to a recent release, aimed its sights at the terminal healthcare provision company Intrepid U.S.A. Inc.
The company, headquartered in Dallas, is alleged to have, alongside its subsidiaries, violated the FCA on multiple counts concerning Medicare.
“Businesses who engage in improper Medicare billing practices undercut the legitimate provision of healthcare services for patients in need,” said U.S. Attorney Andrew Luger for the District of Minnesota.
Intrepid to pay $3.85M to resolve FCA Medicare violations
The Justice Department gave details about two different whistleblower cases that lead to the million-dollar sum being handed out. Jennifer Jones, a former travel nurse, and Pamela Joffe, a former Director of Quality Assessment Performance Improvement and New Business Development, for Intrepid, were the first to raise concerns.
Another case was brought to bear by Marsha Rigney, a former Director of Clinical Excellence and Integrity, and Janet Watts, a former Regional Manager of Clinical Excellence, for Intrepid.
It is alleged that between 2016 and 2021, Intrepid Home Healthcare created Medicare claims of “patients who did not qualify or were not properly certified as eligible for the Medicare home healthcare benefit, where the services provided were not reasonable or medically necessary, where the services were provided by untrained staff, or where services were not performed.”
A secondary claim in the same period also alleged that three intrepid facilities filed Medicare hospice benefit claims for individuals who did not need end-of-life care or were not terminally ill and also kept claiming for patients who should have been discharged.
“Home health is designed to increase health care access for our most vulnerable populations with mobility limitations, while hospice care aims to provide comfort and relief for the terminally ill. Exploiting these systems for financial gain is intolerable,” said Special Agent in Charge Tamala E. Miles of the Department of Health and Human Services Office of Inspector General (HHS-OIG).
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