The U.S. Department of Justice, U.S. Attorney’s Office, Southern District of Texas, announced on October 19, 2017 that Health Services Management Inc. (“HSM”) has paid the United States and the State of Texas $5 million to resolve claims that it billed the Medicare and Medicaid programs for “worthless services and for services that were never provided,” which the company did not admit when agreeing to make the settlement payment.
The settlement payment was the culmination of an investigation that begun after a False Claim Act qui tam whistleblower lawsuit was filed on October 17, 2014 by an employee at the Huntsville Health Care Center, which is a 92-bed nursing home and rehabilitation facility that HSM owned and operated. The whistleblower alleged in her qui tam lawsuit that she witnessed nursing home resident abuse and neglect, inadequate care, physical and verbal abuse, and denial of basic services, including the alleged failure of the nursing home to provide residents with food and water.
The investigation by the United States and Texas into the nursing home neglect and nursing home abuse claims concluded that from January 1, 2013 through December 31, 2015, the Huntsville Health Care Center billed for services that were not provided or which were so substandard and deficient that they were considered worthless and potentially harmful to specific Huntsville patients. The claims for payment to Medicare and Medicaid for those services were deemed by the investigation to be fraudulent and submitted in violation of federal and state law.
As part of the announced settlement, HSM further agreed to enter into a Corporate Integrity Agreement with the U.S. Department of Health and Human Services – Office of Inspector General (“DHHS-OIG”). The Special Agent in Charge of DHHS-OIG stated in the press release, “It’s disturbing when a nursing home company accepts Medicare and Medicaid money to care for vulnerable nursing home residents and in return provides substandard care, as alleged in this case. We will continue to hold nursing homes accountable to give residents the quality health services, and living conditions, taxpayers pay them to provide.”
The whistleblower will receive $1 million from the settlement, as allowed by the False Claims Act and the Texas Medicaid Fraud Prevention Act as an incentive to whistleblowers to bring to light alleged fraudulent conduct and payments affecting federal and state programs, when a whistleblower files an action on behalf of the United States and there is a recovery.
If you have information regarding false claims having been submitted to Medicare, Medicaid, TRICARE, other federal health care programs, or to other federal agencies/programs, and the information is not publically known and no actions have been taken by the government with regard to recovering the false claims, you should promptly consult with a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may also assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.
Click here to visit our website or call us toll-free in the United States at 800-295-3959 to be connected with qui tam lawyers (False Claims Act lawyers) in your U.S. state who may assist you with a False Claims Act lawsuit.
Turn to us when you don’t know where to turn.