Home Health & Hospice Week

Voluntary disclosure minimizes the penalty. 

Home care company Amedisys Inc. may have gotten more than it bargained for when it acquired Monroe Home Health Agency in 1994.

The Baton Rouge, LA-based company has agreed to pay more than $1.1 million to settle claims that Monroe billed Medicare for services it never rendered and submitted improper cost reports to the government, according to Donald Washington, the U.S. Attorney for Western Louisiana.

A joint investigation by Washington's office and the HHS Office of Inspector General revealed Monroe's former administrator orchestrated the alteration of medical records, the falsification of physician and patient signatures and the fabrication of nurses' notes. In addition, Monroe's cost reports inappropriately included salaries of people who didn't really do any work for the HHA.

While virtually all of that happened before Amedisys took over Monroe, the HHA regional chain is still stuck with the bill. However, Washington says Amedisys got a break on the settlement terms for voluntarily disclosing the problems at Monroe and cooperating with investigators.

That's not to say the cost wasn't steep - the settlement represents twice the government's losses - but it wasn't as harsh as the triple damages and $11,000 fines per false claim the feds could have pursued. Amedisys said in March it expected to receive more leniency for self-reporting (see Eli's HCW, Vol. XII, No. 11, p. 86). The company had to set aside $300,000 more than expected to settle the matter. "The self-report process has been an arduous and costly one," CFO Greg Browne said at the time.

As part of the settlement, Amedisys has entered into a three-year corporate integrity agreement with the OIG.