Intrepid U.S.A. Inc., headquartered in Dallas, and its subsidiaries have agreed to pay $3,850,000 to resolve allegations of violating the False Claims Act. The allegations concern claims submitted to Medicare for home healthcare services and hospice care for patients who did not qualify for these benefits. The settlement is based on Intrepid’s ability to pay.
The United States alleged that between 2016 and 2021, 19 Intrepid home healthcare facilities submitted claims for non-qualifying patients or services that were not reasonable or medically necessary. Additionally, it was alleged that three Intrepid hospice facilities admitted ineligible patients or continued providing services to those who no longer met the requirements for the Medicare hospice benefit.
“Medicare’s hospice and home healthcare benefits provide critical services to vulnerable patient populations across the country,” said Principal Deputy Assistant Attorney General Brian M. Boynton of the Justice Department’s Civil Division. “This settlement reflects our commitment to ensuring that these benefits are used to care for those who need them and not just to enrich those who seek to provide them.”
U.S. Attorney Michael A. Bennett for the Western District of Kentucky emphasized the importance of pursuing providers who improperly bill Medicare: “The Medicare Program provides vital health insurance to the elderly and disabled population.”
U.S. Attorney Andrew Luger for the District of Minnesota added, “Businesses who engage in improper Medicare billing practices undercut the legitimate provision of healthcare services for patients in need.”
Special Agent in Charge Tamala E. Miles of HHS-OIG stated, “Home health is designed to increase health care access for our most vulnerable populations with mobility limitations, while hospice care aims to provide comfort and relief for the terminally ill."
The civil settlement resolves claims brought under the qui tam provisions of the False Claims Act by Jennifer Jones and Pamela Joffe in one lawsuit (U.S. ex rel. Jones v. Intrepid USA Healthcare Inc., No. 19-sc-2973) and Marsha Rigney and Janet Watts in another (U.S. ex rel. Rigney v. Intrepid U.S.A. Inc., No. 3:20-cv-95-RGJ). Relators Jones and Joffe will receive $333,985 from the settlement proceeds, while Rigney and Watts will receive $359,014.
The resolution was a coordinated effort involving multiple entities including the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section; U.S. Attorney’s Offices for both districts; and HHS-OIG.
Trial Attorney Anthony Gill of the Civil Division’s Commercial Litigation Branch, Fraud Section; Assistant U.S. Attorney Benjamin Schecter for Western District of Kentucky; and Assistant U.S. Attorney Kristen Rau for District of Minnesota investigated this matter.
It should be noted that these resolved claims are allegations only with no determination of liability.