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Visiting Physicians Association to Pay $9.5 Million to Resolve False Claims Act Allegations

Thursday, December 24, 2009 Medico Legal News J E 4
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WASHINGTON, Dec. 23 Visiting Physicians Association, which is based in Farmington Hills, Mich., will pay the United States and the state of Michigan $9.5 million to settle allegations that the association violated the False Claims Act by submitting false claims to Medicare, TRICARE and the Michigan Medicaid program, the Justice Department announced today. Visiting Physicians Association is a Michigan professional corporation which has provided home health services at various times in Michigan, Ohio, Georgia and Wisconsin.

The agreement announced today settles allegations that Visiting Physicians Association submitted claims to the Medicare, TRICARE and Michigan Medicaid for unnecessary home visits and care plan oversight services, for unnecessary tests and procedures, and for more complex evaluation and management services than the services that Visiting Physicians Association actually provided.

"This settlement illustrates the government's commitment to pursuing those who defraud Medicare and other important programs and drive up the costs of health care," said Tony West, Assistant Attorney General for the Civil Division of the Department of Justice. "The Justice Department will continue to work with our federal and state partners to ensure that taxpayer dollars are spent on health care services for patients, not wasted on fraud and abuse."

"This settlement furthers the public interest and protects the strength and soundness of the Medicare program while ensuring that Medicare beneficiaries receive appropriate care. Cooperation between federal and state entities is crucial to this effort," said Carter Stewart, U.S. Attorney for the Southern District of Ohio.

"My office is committed to ensuring that healthcare providers are reimbursed only for legitimate services provided to qualified beneficiaries. We will use all tools available to us, including civil enforcement remedies, to maintain the integrity of government programs," said Terrence Berg, U.S. Attorney for the Eastern District of Michigan.

This settlement resolves four lawsuits filed by private plaintiffs under the qui tam or whistleblower provisions of the False Claims Act, which permit private parties to file an action on the government's behalf and share in any recovery. This settlement provides that the four whistleblower plaintiffs will collectively receive a total of approximately $1.7 million.

The U.S. Department of Health and Human Services, Office of Inspector General; the FBI; and the Michigan Attorney General's Office investigated this matter. The Justice Department's Civil Division, the U.S. Attorney's Office for the Southern District of Ohio, the U.S. Attorney's Office for the Eastern District of Michigan, and the Michigan Attorney General's Office handled the lawsuits.

SOURCE U.S. Department of Justice
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