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Justice News

Department of Justice
U.S. Attorney’s Office
District of Rhode Island

FOR IMMEDIATE RELEASE
Monday, September 28, 2015

$2.6 Million Recovered Through Settlement of False Claims Act Allegations Against American Access Care

PROVIDENCE, R.I. - United States Attorney Peter F. Neronha and Phillip Coyne, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), New England Region, announced today that American Access Care Holdings, LLC, (AAC) which handled billings and claims submitted by a vascular access center formerly operated by AAC in Providence, R.I., has agreed to pay $2.6 million dollars to resolve allegations that it violated the False Claims Act as a result of conduct at its Providence access center. 

Among other services, access care facilities address complications with dialysis access for patients with kidney disease.  In this case, the Government alleged that AAC violated the False Claims Act through its knowing submission of three types of claims: (1) billing Medicare for percutaneous transluminal angioplasties (PTAs) that were medically unnecessary under Medicare guidance; (2) billing for more PTAs per patient encounter than permitted; and (3) billing for medically unnecessary procedures during follow-up visits.

 “Doctors and companies that choose to collect federal healthcare dollars must do so with a clear understanding that those dollars come with responsibilities – first and foremost, that all care is billed because it’s necessary for the patient, not the bottom line,” announced U.S. Attorney Neronha. “Today’s settlement is a reminder that we will continue to vigorously police compliance with program standards to ensure that taxpayer dollars are spent only in the appropriate manner.”

“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 Special Agent in Charge Philip Coyne of the U.S. Department of Health and Human Services Office of Inspector General.  “Our agency is dedicated to investigating health care fraud schemes that divert scarce taxpayer funds meant to provide for legitimate patient care.”

The government’s case was resolved under the federal False Claims Act, which allows the United States to recover federal funds that are paid out as a result of knowingly false or fraudulent claims, along with multiple damages.   The Rhode Island settlement is concluded simultaneously with the resolution of claims against AAC by the United States Attorney for the District of Connecticut, and follows a third settlement against this company in the Southern District of Florida, in the case United States ex rel. Souza v. American Access Care of Miami, LLC (S.D. Fla.).

Former AAC facilities, including the one in Providence, are now operated by Fresenius Vascular Care, Inc. The conduct addressed by the settlement agreement took place prior to the merger between the two entities. 

The investigation of this matter is the result of a coordinated effort between the U.S. Attorney’s Office for the District of Rhode Island and HHS-OIG.

The matter was litigated by Assistant U.S. Attorneys Zachary A. Cunha and Mary E. Rogers.

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Contact:

Jim Martin (401) 709-5357

email: USARI.Media@usdoj.gov

on Twitter @USAO_RI

 

15-88
Topic: 
Healthcare Fraud
Updated September 28, 2015