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Louisville based MD2U admits to violating False Claims Act MD2U, a regional provider of home-based care, and its principal owners admit to violating the federal false claims act and being liable for millions. Knowingly presented false claims and altered records to get false claims paid. Will pay millions to settle allegations Click on headline for complete story From U.S. District Attorney's Office U.S. Justice Department, Western District of Kentucky LOUISVILLE, KY - MD2U Holding Company, including its related companies and individually named owners ("Defendants"), have agreed to pay millions to resolve a government lawsuit alleging that they violated the federal False Claims Act by knowingly submitting false medical claims to Medicare and other government health care programs, altering records to support false claims, and providing services that were medically unnecessary U.S. Attorney John E. Kuhn, Jr. today announced. "Unfortunately, our healthcare system is under assault from a small minority of providers who engage in fraudulent billing, overbilling, and providing unnecessary services," stated U.S. Attorney Kuhn. "In an effort to control these losses and force accountability, my office and the Department of Justice pursues and recovers false and fraudulent billings as one of its highest priorities. This significant case against MD2U is but one example of the vigorous work against healthcare fraud taking place in the Western District and across the nation." "This provider billed for medically unnecessary home visits and often grossly exaggerated the level of service provided," said Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General in Atlanta. "The OIG is committed to protecting the integrity of federal health care programs by aggressively pursuing entities that increase their revenue through deceitful schemes and trickery." The government's complaint alleged that between July 1, 2007, and November 30, 2014, MD2U submitted false billings for patients who were neither homebound nor home-limited; improperly billed the government for medically unnecessary visits; billed government health care programs at the highest payment codes (upcoding) when a lower code would have been more appropriate; and cloned medical records (a cut, copy, paste electronic program) in order to justify patient visits. Specifically, the government's complaint alleged that MD2U's schemes included the following:
Further, in the Consent Judgment to be entered by the Court, defendants J. Michael Benfield, Chief Executive Officer and President of MD2U; Greg Latta, Chief Information Officer; and Karen Latta, Chief Operations Officer, all owners, residing in Louisville, admit that, due in part to the actions of a former employee, they caused the submission of false claims to the United States in violation of the False Claims Act. They further admit that the submission of the claims for payment caused these damages as a result of misrepresentations, false representations, and/or deceptive conduct; that it was done with reckless disregard of the falsity of the claims; and in doing so, caused the United States of America to be deceived. Through the terms of the Stipulation and Order, the Defendants can fulfill their obligations to pay the Consent Judgment by paying $3.3 million and a percentage of MD2U's net income over the next five years. The Defendants have also agreed to enter into a five year Corporate Integrity Agreement with the Department of Health and Human Services, Office of Inspector General. The settlement announced today illustrates the government's emphasis on combating health care fraud and marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation. One of the most powerful tools in this effort is the False Claims Act. Since January 2009, the Justice Department has recovered a total of more than $27.1 billion through False Claims Act cases, with more than $17.1 billion of that amount recovered in cases involving fraud against federal health care programs. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, including the conduct described in the United States' complaint, can be reported to the Department of Health and Human Services, at 800-HHS-TIPS (800-447-8477). This matter was handled by Assistant United States Attorney Benjamin S. Schecter with the U.S. Attorney's Office for the Western District of Kentucky, the Department of Health and Human Services, Office of Inspector General; Defense Criminal Investigative Services; and the Railroad Retirement Board, Office of the Inspector General. The case is captioned United States v. MD2U Holding Company et al., Case No. 3:16-cv-00440-GNS. This story was posted on 2016-07-09 03:57:47
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