WASHINGTON – The United States has intervened in a lawsuit against Nurses’ Registry and Home Health Corporation in the U.S. District Court for the Eastern District of Kentucky, the Justice Department announced today. The lawsuit was filed in March 2008 by two former Nurses’ Registry employees, Alicia Robinson-Hill and David Price, and alleges among other things that Nurses’ Registry made false claims to Medicare for medically unnecessary home health services.
According to the complaint, Nurses’ Registry exaggerated the medical conditions and needs of its patients for home health care services, both at the start of service and for additional and continuing care, in order to qualify for, and artificially increase, its claims to Medicare. The Lexington, Ky., company, according to its website “provides a wide range of home health care services including skilled nursing, physical and occupational therapies, in-home IV therapy, homemaker aid (bathing, dressing, grooming), and private duty.”
The lawsuit was filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private parties to sue on behalf of the United States and share in any recovery. The False Claims Act permits the government to recover three times its damages, plus civil penalties. The government has asked the court for 45 days to file its own complaint stating the United States’ allegations.
“Home health care providers furnish essential services to some of our most vulnerable citizens,” said Tony West, Assistant Attorney General for the Justice Department’s Civil Division. “Those who misstate the conditions of their patients for their own financial gain erode the integrity of the health care system, and they do it at taxpayers’ expense.”
“This complaint alleges serious and extensive health care fraud,” said Kerry Harvey, U.S. Attorney for the Eastern District of Kentucky. “Our office is committed to rooting out such fraud, and after investigating the allegations we concluded that it was appropriate to pursue these claims in court.”
This intervention decision is part of the government’s emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced by Attorney General Eric Holder and Kathleen Sebelius, Secretary of the Department of Health and Human Services in May 2009. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in that effort is the False Claims Act, which the Justice Department has used to recover more than $5.9 billion since January 2009 in cases involving fraud against federal health care programs. The Justice Department’s total recoveries in False Claims Act cases since January 2009 are more than