Home Health & Hospice Week

Providers fending off whistleblower cases may be heartened by a recent unpublished ruling from the Eleventh Circuit Appeal Court.

In Helmly v. Bethany Hospice and Palliative Care of Coastal Georgia, the federal appeals court affirms a lower court ruling dismissing a qui tam complaint from former administrator Debbie Helmly and marketer Jolie Johnson against Bethany Hospice. Bethany paid physicians for hospice referrals based on sham “ownership interests,” Helmly and Johnson claimed. Bethany also offered to pay Helmly the same way, she said.

The lower court shot down the suit, and the appeals court agrees, noting that the whistleblowers “failed to allege particular facts about the precise nature of the kickback incentives and how much [the co-owner] paid for referrals.” The relators also failed to “provide specific dates that Bethany Hospice paid doctors, the amounts doctors were paid, or any specific patient in the reports,” the ruling notes.

The suit also “(1) failed to describe Bethany Hospice’s billing operations in sufficient detail, (2) failed to describe a single example of when Relators observed a false claim being submitted, [and] (3) did not themselves participate in the submission of false claims,” the court points out.

See the ruling at https://law.justia.com/cases/federal/appellate-courts/ca11/20-11624/20-11624-2021-04-26.html.