Many elderly Americans need medical care at home…they don’t need or want to be in hospital and certainly want to avoid being placed in nursing home. What these individuals need is trained and attentive home health services…and most of the providers (nurses and nursing aids) are just that…competent and caring professionals.
My beef is with the companies that hire these providers, companies like Carter Healthcare LLC, along with its affiliates CHC Holdings and Carter-Florida (collectively Carter Healthcare). Why? Because they provide therapy without regard to medical necessity and overbill for therapy by upcoding patients’ diagnoses. We know this because a “whistleblower,” likely someone on the inside of Carter Healthcare like billing/coding personnel or an employee in the finance department, reported their actions to the Department of Justice (DOJ). The DOJ then filed a successful False Claims Act suit against Carter Healthcare (DOJ report here).
What is the effect of this corporate fraud? It means Carter Healthcare billed for medical services that were not necessary or billed Medicare more than permitted under its guidelines.
Who suffers from these acts of fraud? First, the patients who need competent care. Second, American taxpayers who fund Medicare…that is right people like you and me.
Thanks to the whistleblower and his/her attorney, home health provider Carter Healthcare LLC, along with their President Stanley Carter and Chief Operations Officer Bradley Carter will pay $7.175 million to settle allegations that they violated the False Claims Act by overbilling the Medicare program. Read the whole story here.
If you have knowledge of fraudulent conduct by a home health care provider, call us for a confidential discussion about what you can do.