On August 20, the U.S. Department of Justice announced that Intrepid U.S.A. Inc., headquartered in Dallas, and various wholly-owned subsidiaries (Intrepid) have agreed to pay $3,850,000 to resolve allegations that they violated the False Claims Act for knowingly submitting fraudulent Medicare claims for home healthcare services.
According to the government, “between 2016 and 2021, 19 Intrepid home healthcare facilities submitted claims to Medicare for home healthcare services for patients who did not qualify or were not properly certified as eligible for the Medicare home healthcare benefit, where the services provided were not reasonable or medically necessary, where the services were provided by untrained staff, or where services were not performed.”
The government also alleged that during the same period, three Intrepid hospice facilities admitted and provided service patients to hospice care who were ineligible for the Medicare hospice benefit because they no longer met the requirements for the benefit
U.S. Attorney Andrew Luger for the District of Minnesota stated, “Businesses who engage in improper Medicare billing practices undercut the legitimate provision of healthcare services for patients in need. This settlement reinforces the importance of holding accountable health care providers who seek financial gain above quality patient care.”
The settlement stems from two qui tam whistleblower suits filed by Jennifer Jones, a former travel nurse, Pamela Joffe, a former Director of Quality Assessment Performance Improvement and New Business Development for Intrepid, Marsha Rigney, a former Director of Clinical Excellence and Integrity, and Janet Watts, a former Regional Manager of Clinical Excellence, for Intrepid.
The False Claims Act prohibits knowingly submitting false statements to obtain money or property from the government or avoiding a legal obligation to pay the government. Qui tam is a key provision under the FCA that deters fraud by empowering individuals to file qui tam lawsuits on behalf of the government. Whistleblowers can receive awards ranging from 15% to 30% of the total amount the government recovers from the defendant through settlements, judgments, or fines.
In this settlement, Relators Jones and Joffe will receive $333,985 from the settlement proceeds, and Relators Rigney and Watts will receive $359,014 from the settlement proceeds.
“This settlement reflects our commitment to ensuring that these benefits are used to care for those who need them and not just to enrich those who seek to provide them,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division.
In July 2023, 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.
National Whistleblower Center (NWC) 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
