Healthcare Associates has agreed to pay $16.5 million to resolve civil allegations that it improperly billed Medicare for services provided to patients in nursing facilities, according to reporting by Bloomberg Law. The settlement addresses claims brought under the False Claims Act and resolves the matter without a trial or a judicial finding of liability.
The government alleged that Healthcare Associates submitted claims for medically unnecessary services and failed to comply with Medicare billing and supervision requirements, resulting in improper reimbursements from the federal healthcare program.
Allegations Involving Medicare Billing
According to the allegations outlined in the civil case, Healthcare Associates provided medical services to residents in nursing facilities but billed Medicare in ways that allegedly violated program rules. The government claimed the company:
-
Submitted claims for medically unnecessary services
-
Failed to properly supervise non-physician practitioners
-
Billed for services that did not meet Medicare coverage requirements
Federal authorities contended that these practices resulted in the submission of false claims to Medicare. While the conduct was alleged to involve committing Medicare fraud, the settlement resolves civil allegations only and does not constitute a criminal conviction or admission of wrongdoing.
Whistleblower Lawsuit Led to the Settlement
The case originated as a qui tam whistleblower lawsuit filed under the False Claims Act. Whistleblower actions allow private individuals with knowledge of fraud involving government funds to bring claims on behalf of the United States.
Such lawsuits play a critical role in uncovering improper billing practices that may otherwise go undetected, particularly in complex healthcare reimbursement systems like Medicare.
No Admission of Liability
As with many False Claims Act settlements, Healthcare Associates entered into the agreement to resolve disputed claims without admitting liability. The settlement reflects a negotiated resolution of allegations, not a determination of guilt by a court.
Why Whistleblowers Matter
Cases like this underscore the importance of whistleblowers in protecting taxpayer-funded healthcare programs. By coming forward with information about alleged misconduct, whistleblowers help ensure that Medicare funds are used appropriately and that providers comply with federal requirements.
Contact The Whistleblower Advocates
If you have information about improper Medicare billing or other misconduct involving government healthcare programs, Our Philadelphia Whistleblower Advocates team offers free and confidential consultations. Our attorneys help individuals understand their rights under the False Claims Act and guide them through the whistleblower process while protecting their legal interests.
This article is a news article for informational purposes only. The Whistleblower Advocates did not represent the parties identified in the story above.
