Home Health & Hospice Week

Qui tam suit revolves around homebound status

Make sure you’re following Medicare regulations, or one of your employees — even executives — may be only too happy to benefit from it.

Alabama home care company Techota is learning that lesson the hard way. The company that owns home health agencies operating in rural Alabama will pay $150,000 to settle a whistleblower lawsuit filed in 2011, reports The Birmingham News. Fifteen percent of that amount will go to registered nurse Veronica McDonald, who was the agency director of Techota’s Cahaba Valley Home Health at the time. Techota also must pay $27,500 for McDonald’s legal fees.

When McDonald was employed in October 2010, she “immediately became aware that CV Home Health’s business practices [were] designed to fraudulently inflate billing … by falsely representing the type and severity of patients’ medical conditions,” according to her lawsuit. “Ms. Mc-

Donald was consistently instructed to falsify and alter patient assessments and nursing notes to create the false appearance that patients required skilled care and qualified for the Medicare home health benefit, resulting in false claims,” the newspaper reports.

For example: The lawsuit cites one case in which a patient requested that the home health nurses visit him at his job “because he was too busy to be home every time nurses came to provide treatment,” says McDonald’s law firm Frohsin & Barger in a release. In other cases, “nurses did little more than deliver cigarettes to people and sit with them watching television,” the release says.

The Department of Justice joined in a portion of the lawsuit. Techota also has agreed to enter a Corporate Integrity Agreement with the HHS Office of Inspector General.