Government Settles False Claims Act Allegations against American Access Care Holdings, LLC for $3.5 Million
Deirdre M. Daly, United States Attorney for the District of Connecticut, and Philip Coyne, Special Agent in Charge of the U.S. Department of Health and Human Services Office of Inspector General, today announced that AMERICAN ACCESS CARE HOLDINGS, LLC has entered into a civil settlement agreement with the Government in which it will pay $3,594,791 to resolve allegations that it violated the False Claims Act.
Prior to its merger with Fresenius Vascular Care, Inc. (“Fresenius”) in October 2011, AMERICAN ACCESS CARE HOLDINGS, LLC (“AAC”) operated a number of vascular access centers in the United States, including one in Fairfield, Connecticut. Among other services, vascular access centers address complications with dialysis access for patients with kidney disease. The government alleges that, between January 2007 and September 2011, AAC improperly billed Medicare and Medicaid for multiple percutaneous transluminal angioplasties performed during the same patient encounter. The government also alleges that, between October 2005 and September 2011, AAC improperly submitted claims to Medicare and Medicaid for procedures performed during follow-up visits that were not medically necessary.
The conduct addressed by the settlement occurred prior to the merger with Fresenius.
“It is imperative that all health care providers bill only for appropriate and necessary medical treatments and bill for such services accurately and honestly,” said U.S. Attorney Daly. “The U.S. Attorney’s Office will vigorously investigate any provider that submits fraudulent claims to Medicare or Medicaid as this misconduct cheats the system, increasing the cost of health care for all of the rest of us.”
“Health care providers will not be permitted to provide unnecessary medical procedures – in this case, invasive procedures – on patients and then pocket the improper payments they receive as a result,” said HHS-OIG Special Agent in Charge Coyne. “Our agency is dedicated to investigating health care fraud schemes that divert scarce taxpayer funds meant to provide for legitimate patient care.”
The Connecticut settlement is related to a parallel resolution of claims against AAC by the U.S. Attorney for the District of Rhode Island, and follows a third settlement against the company in the Southern District of Florida, in the case United States ex rel. Souza v. American Access Care of Miami, LLC.
In entering into the civil settlement agreement, AAC did not admit liability and disputes the government’s allegations.
This matter was investigated by the Office of Inspector General for the Department of Health and Human Services, and the Federal Bureau of Investigation. The case is being prosecuted by Assistant U.S. Attorney Richard M. Molot and Auditor Kevin Saunders.
People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at (203) 777-6311.