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Hospice to pay $2.4 Million to resolve False Claims Act Allegations

Compassionate Care Hospice Group, Inc., (“CCH Group”) has agreed to pay $2.4 million to resolve allegations that CCH Group and its subsidiary Compassionate Care Hospice of Atlanta, LLC, (“CCH Atlanta”) submitted or caused the submission of false claims to Medicare and Medicaid by engaging in improper financial relationships with contracted physicians. CCH Group is a Florida corporation with its principal place of business in Parsippany, New Jersey, and subsidiaries and affiliates in numerous states.

“Kickbacks should never play a role in medical decision-making,” said U.S. Attorney John Horn. “When healthcare providers are paid for referrals, the costs of health services inevitably rise and ultimately are borne by taxpayers.”

“The False Claims Act settlement in this case should be a deterrent to those who would so selfishly circumvent our federal healthcare programs to their benefit,” said FBI Special Agent in Charge David J. LeValley. “Rest assured the FBI is committed to diligently investigating those who would defraud our federally funded healthcare programs, depriving those who truly depend on them.”

“It is paramount to our health care system that those seeking health care advice know that providers and treatments recommended to them are not influenced by illegal remuneration or arrangements,” said Special Agent in Charge Derrick L. Jackson, of the U.S. Department of Health and Human Services, Office of Inspector General. “The OIG is committed to working with our law enforcement partners to combat this sort of activity.”

“Our office’s Medicaid Fraud Control Unit will continue to work with our federal partners to go after any action that compromises the integrity of our health care systems,” said Georgia Attorney General Chris Carr. “This type of scheme obscures the proper relationship among those providing health care services to Medicaid members, and it diminishes the quality of health care options available to our citizens. We won’t stand for it.”

The government alleges that, between April 3, 2007 and April 29, 2011, CCH Group and CCH Atlanta paid illegal remuneration to five physicians in order to induce the providers to refer patients to CCH Atlanta for hospice services and certify individuals as eligible for hospice services. The government also alleges that CCH Atlanta and CCH Group submitted or caused the submission of claims to Medicare and Medicaid for services provided to the individuals who had been referred by the physicians because of the kickbacks. The illegal remuneration took the form of (1) payments to a medical director in exchange for referrals and (2) sham contracts with associate medical directors in exchange for referrals.

The settlement resolves allegations filed by Cathy Morris and Josie King, former CCH Atlanta employees, under the qui tam, or whistleblower, provisions of the False Claims Act, which authorizes private parties to sue for false claims on behalf of the United States and share in the recovery. The lawsuit was filed in the Northern District of Georgia and is captioned United States & State of Georgia ex rel. Morris & King v. Compassionate Care Hospice Group of Atlanta, LLC, et al., No. 1:10-cv-3450 (N.D. Ga.). Ms. Morris and Ms. King will receive a share of the settlement.

The claims resolved by the settlement are allegations only, and there has been no determination of liability.

This case was investigated by the U.S. Attorney’s Office for the Northern District of Georgia, the U.S. Department of Health & Human Services Office of Inspector General, the Federal Bureau of Investigation, and the Georgia State Attorney General’s Medicaid Fraud Control Unit.

The civil settlement was reached by Assistant U.S. Attorneys Lena Amanti and Neeli Ben-David and Georgia State Assistant Attorney General Sara Vann.