Saad Enterprises Inc., operating as Saad Healthcare, has agreed to pay $3 million to settle allegations of violating the False Claims Act. The company was accused of knowingly submitting false claims for hospice care in Alabama for patients who were not terminally ill and therefore ineligible for Medicare hospice benefits.
Hospice care is designed to comfort terminally ill patients, focusing on relief from symptoms and stress rather than curing the illness. Medicare considers patients eligible for hospice care if they have a life expectancy of six months or less under normal circumstances.
"Respectful and appropriate end-of-life care is the crux of the hospice benefit under Medicare," stated Principal Deputy Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division. "The Department will hold accountable those who exploit this benefit for their own gain."
Acting U.S. Attorney Keith A. Jones for the Southern District of Alabama emphasized, "Caring for terminally ill people is a responsibility the United States and the Medicare program take seriously. Patients and taxpayers deserve not to be cheated, and the Department of Justice will continue to protect them."
The settlement addresses allegations that between 2013 and 2020, Saad submitted false claims for 21 patients who did not meet Medicare's eligibility requirements for hospice benefits. These claims were resolved through a lawsuit filed under the qui tam provision of the False Claims Act, which allows private parties to sue on behalf of the United States and share in any recovery. The whistleblower lawsuit was filed by former Saad employees Melissa Wolff and Whitney Sims, identified as United States ex rel. Wolff & Sims v. Saad Enterprises, Inc., Case No. 1:19-cv-00040 (S.D. Ala.). Wolff and Sims will receive $540,000 from the settlement.
This resolution resulted from coordinated efforts by several entities including the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section; U.S. Attorney’s Office for the Southern District of Alabama; and Department of Health and Human Services Office of Inspector General.
The case highlights government efforts to combat healthcare fraud using tools like the False Claims Act. Reports on potential fraud can be directed to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).
Assistant U.S. Attorney Nina Herring for the Southern District of Alabama and Trial Attorney Rory Skaggs from the Civil Division handled this matter.
The allegations resolved by this settlement are just that—allegations—and there has been no determination of liability.