Home Health & Hospice Week

Insurance covers $15 million.

Three years after coughing up $150 million to settle Medicare billing fraud charges, Amedisys Inc. has agreed to pony up another $43.75 million to settle a class action lawsuit from shareholders.

Reminder: The Baton Rouge, La.-based company first revealed the $150 million settlement in November 2013, then it was finalized the following May. The billing violations at the base of the settlement “were the alleged result of management pressure on nurses and therapists to provide care based on the financial benefits to Amedisys, rather than the needs of patients,” the Department of Justice said in a release. The charges were first reported by the Wall Street Journal, which sparked a Senate hearing and the DOJ investigation (see Eli’s HCW, Vol. XIX, No. 19).

All parties in the class action lawsuit Bach, et al. v. Amedisys, Inc., et al., Case No. 3:10-cv- 00395 “executed a binding term sheet that, subject to final documentation and court approval, provides in part for a settlement payment of $43.75 million and the dismissal with prejudice of the litigation,” Amedisys says in a June 16 8-K filing with the Securities and Exchange Commission. “Approximately $15 million of the settlement amount will be paid by the Company’s insurance carriers,” the filing says.

The for-profit, publicly traded chain “is settling the case to eliminate uncertainties, risk, distraction and expense associated with this protracted litigation, and neither the Company nor any individual defendant concedes or admits liability,” according to the filing.