Whistleblower's Home Health Fraud Case Settles for $6.65 Million

On January 31, 2018, Richard P. Donoghue, United States Attorney for the Eastern District of New York announced that Home Family Care, Inc. (HFC), a Brooklyn-based company that provides home health care services, and Alexander Kiselev, the co-owner and President of HFC, have agreed to pay $6,415,000 to resolve allegations that they violated the federal and state False Claims Acts by falsely billing Medicaid for home health care services that HFC did not actually provide to Medicaid recipients.  HFC’s former Vice President, Michael Gurevich, has agreed to pay $140,000 to federal and state authorities in a separate settlement regarding the same allegations.

This case was originally brought to the attention of federal and state authorities by a whistleblower, known as a relator, under the qui tam provisions of the False Claims Act.  The qui tam provisions allow private citizens with knowledge of fraud against the government to bring a lawsuit on behalf of the United States and share in any recovery.  The relator who brings a qui tam action is entitled to receive between 15-30 percent of the Government’s total recovery – which can be as much as three times the amount the Government was defrauded, plus civil monetary penalties for each false claim for payment.  The amount of money the Relator, a former employee of HFC, will receive in this case has not been released.

Based on the Whistleblower’s allegations, an investigation revealed that from the time HFC began operating in 2008 until at least May 2014, HFC engaged in a fraudulent scheme to enrich itself at the expense of Medicaid by knowingly and systematically billing for home health aide and personal care aid services that were not in fact provided to Medicaid recipients.  To carry out this scheme, HFC directed its employees to falsely verify the attendance of aides at the homes of Medicaid recipients for whom the aides were allegedly providing care and to deliberately circumvent HFC’s internal controls that purported to ensure that aides were present in the recipients’ homes.

“When health care providers seek and receive Medicaid funds for services that they never provided, they jeopardize the fiscal integrity of a critical health care program,” stated United States Attorney Donoghue.  “We will hold health care providers accountable for their violations of federal law.”  Mr. Donoghue thanked the Medicaid Fraud Control Unit of the Office of the New York State Attorney General, the Office of the Inspector General of the U.S. Department of Health and Human Services, and the New York Office of Field Operations and the Office of Associate Chief Counsel (New York) of U.S. Customs and Border Protection for their assistance in the investigation.

Frohsin Barger & Walthall would like to thank and congratulate these law enforcement agencies as well as the brave relator who came forward to expose this fraud.  We would also like to thank and congratulate the Relator’s counsel, Alan G. Lebenbaum of Alan Lebenbaum, Attorney-At-Law in Brooklyn, New York for his vital role in returning over $6.5 million to the taxpayers of the United States and State of New York.

To learn more about the False Claims Act and Home Health Fraud, click here.