On May 1, the Department of Justice (DOJ) announced that Elara Caring and its wholly owned subsidiaries agreed to pay $4.2 million to resolve allegations of False Claims Act (FCA) violations. These alleged violations involved the conscious submission of false claims and the retention of overpayments for hospice patients who were not eligible for Medicare benefits in Texas.
Aneko Jackson, a former Elara Caring employee, filled a qui tam lawsuit bringing forward the allegations. Jackson will be awarded $672,000 from the settlement. The FCA’s qui tam or whistleblower provisions allow private individuals to file suit alleging FCA violations and to receive a share of the government’s recovery.
The settlement addresses allegations that Elara Caring’s branch in Texarkana, Texas, formerly operating as CIMA Hospice, intentionally filed false claims to provide hospice services to patients who were ineligible for the benefit because they were not terminally ill. This allegedly occurred at the location between 2014 and 2019, and 2020. Additionally, the settlement addresses allegations concerning two patients at other Texas locations between 2015 and 2021. It also resolves allegations that Elara Caring knowingly and wrongfully concealed or avoided obligations to repay overpayments for these patients.
The Principal Deputy Assistant Attorney General, Brian M. Boynton, who heads the Justice Department’s Civil Division, said “The hospice benefit under Medicare provides critical services to vulnerable patients. The department will continue to ensure that this benefit is used to assist those who need it, and not to line the pockets of those who seek to abuse it.”
On July 25, a bipartisan group of senators introduced the False Claims Amendments Act of 2023, which address a few technical loopholes undermining the success of the FCA. The bill is widely supported by whistleblower advocates.
“The False Claims Act is America’s number one fraud-fighting law,” said whistleblower attorney Stephen M. Kohn. “These amendments are urgently needed to ensure that whistleblowers can continue to play their key role in protecting taxpayers from corporate criminals.”
Kohn sees the passage of the False Claims Amendments Act as one of the seven most urgently needed whistleblower reforms. National Whistleblower Center (NWC), where Kohn serves as Chairman of the Board, has issued an Action Alert calling on Congress to pass the bill.
Join NWC in Taking Action:
Demand that Congress strengthen the False Claims Act
Further Reading:
Bipartisan Legislation Unveiled to Strengthen False Claims Act