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Company agrees to pay penalty and implement compliance program to resolve claims arising from alterations to physician orders for home healt care services
GRAND RAPIDS, MICHIGAN – Advanced Professional Home Health Care, a home health agency based in Troy, with offices in Grand Rapids and Flint, has entered into an agreement with the U.S. Attorney’s Office for the Western District of Michigan that requires the agency to pay $57,000 and to implement a compliance program relating to its documentation of physician orders for home health services. The settlement resolves allegations that Advanced Professional Home Health Care violated the False Claims Act by altering physician signature dates and other information on certain physician orders for home health care services that the government examined during its investigation.
Under the terms of the settlement agreement, Advanced Professional Home Health Care has agreed to implement and maintain a compliance program for at least two years. This compliance program requires the company to provide training to its staff regarding medical records and documentation requirements, including those relating to signature and retention requirements for home health care orders. In addition, the company is required to hire an independent firm to perform unscheduled and unannounced reviews for each of the next two years to evaluate the company’s physician orders for home health care services and its billings, claims, and reimbursements based on these orders.
This case resulted from a civil lawsuit filed by a whistleblower who worked in one of Advanced Professional Home Health Care’s offices. The lawsuit, known as a qui tam action, was filed under the False Claims Act, which allows private whistleblowers to bring lawsuits on behalf of the United States and receive a share of any recoveries. In this case, the United States intervened in the whistleblower’s lawsuit. The whistleblower will receive a portion of the settlement proceeds, as well as additional amounts from the company for attorney’s fees and costs.
The U.S. Attorney’s Office for the Western District of Michigan investigated this case. Assistant U.S. Attorney Ryan D. Cobb represented the United States.