Diversicare Healthcare Services and two individual Certified Occupational Therapy Assistants, Kellie S. Lemons and Charles M. James, will pay $1,377,696.00 to resolve allegations that they fraudulently billed Medicare for services that were never rendered to patients, according to a DoJ press release announcing the settlement.  The lawsuit was initiated by national whistleblower law firm, Frohsin Barger & Walthall,  which has posted recoveries approaching half a billion dollars under the False Claims Act for its clients and the United States.

According to the civil complaint, Lemons and James routinely clocked into work at one of Diversicare’s facilities in Phenix City, Alabama, and then left the facility to “moonlight” for other home health care companies.  The $1.3 million settlement resolves allegations that Diversicare knew that the therapy assistants weren’t performing any services but billed Medicare for Lemons and James anyway.  Healthcare fraud involving services that are never performed is unfortunately a widespread and common practice and most often goes undetected.  False Claims Act whistleblower suits are the primary line of defense against such practices that not only are a drain on the already overly-strained national healthcare system but also a potential danger to patients who don’t receive the much-needed care to which they are entitled.

In 2022 alone, the False Claims Act was responsible for addressing over $1.7 billion in healthcare fraud.  Since 2008, Frohsin Barger & Walthall has been singularly dedicated to prosecuting matters under the False Claims Act and has focused primarily on healthcare fraud.  “We believe that when companies contract to provide services for the United States they enter a sacred trust with the citizens of this country to deal squarely and act honorably,” said Jim Barger Jr.  “Unfortunately, all too often companies are willing to cheat their own country,  to cut corners, and look for ways to make an unscrupulous profit.  In this case the company allegedly billed for services it didn’t even provide at all.”

Rather than have the case heard by a jury and risk being held liable for the alleged fraud, Diversicare and the therapy assistants elected to pay for a release of liability, foregoing their right to profess their innocence at trial.  Under the agreement with the United States, the settlement is neither an admission of liability by the Defendants nor a concession by the United States that its claims are not well founded.

If you are aware of similar allegations of healthcare fraud, you may be entitled to an award.  The attorneys at Frohsin Barger & Walthall literally wrote the book on healthcare fraud and would be happy to provide a free initial consultation to discuss your situation and potential claim.