On August 20, the Department of Justice (DOJ) announced that Intrepid U.S.A. Inc., headquartered in Dallas, along with its various wholly-owned subsidiaries, has agreed to pay $3.85 million to resolve allegations under the False Claims Act. These allegations involved claims submitted to Medicare for home healthcare and hospice services that were allegedly ineligible for reimbursement.
The case originated from whistleblower lawsuits filed under the qui tam provisions of the False Claims Act by former Intrepid employees. The whistleblowers, including a travel nurse, a Director of Quality Assessment Performance Improvement, a Director of Clinical Excellence and Integrity, and a Regional Manager of Clinical Excellence, alleged that Intrepid was submitting false claims to Medicare. The government investigated these claims, leading to this settlement. Under the False Claims Act, whistleblowers who bring forward such cases can receive a portion of any recovery, and in this instance, they received a total of $692,999 from the settlement.
According to the DOJ, between 2016 and 2021, 19 of Intrepid’s home healthcare facilities submitted claims to Medicare for services provided to patients who did not qualify for the Medicare home healthcare benefit. The allegations also included claims that the services provided were not reasonable or medically necessary, were provided by untrained staff, or, in some cases, were not provided at all. Additionally, three of Intrepid’s hospice facilities were accused of admitting patients who were not terminally ill and thus not eligible for the Medicare hospice benefit, or continuing care for patients who no longer met the criteria for the hospice benefit.
The DOJ stated that the settlement is based on Intrepid’s ability to pay, and that the resolution of these claims reflects the government’s commitment to ensuring that Medicare funds are used appropriately.
For healthcare providers, it’s crucial to maintain strict compliance with Medicare regulations to avoid potential legal issues. Regular audits, proper training, and accurate documentation can help prevent the submission of ineligible claims. Providers should also seek legal counsel when questions arise about the eligibility of services for Medicare reimbursement or if they face a government investigation.
The attorneys at Chilivis Grubman represent clients of all types and sizes in connection with the False Claims Act and other white-collar investigations. If you need assistance with such a matter, please contact us today.