Healthcare Fraud: Family Care Visiting Nurse and Home Care Agency, LLC Charged and Pay $5.25 Million For Submit Fraudulent Claims
Connecticut Home Health Agency and its Owners Pay $5.25 Million to Settle False Claims Act Violations
United States Attorney Deirdre M. Daly and Connecticut Attorney General George Jepsen today announced that Family Care Visiting Nurse and Home Care Agency, LLC (Family Care VNA), and David A. Krett and Rita C. Krett, R.N., B.S.N., owners of Family Care VNA, have entered into a civil settlement with the federal and state governments in which they will pay approximately $5.25 million to resolve allegations that they violated the federal and state False Claims Acts. Family Care VNA has offices in Stratford, Woodbridge, Norwalk and Meriden, and provides home health services in Fairfield, New Haven, Hartford and Middlesex Counties.
“Home Health Care providers and other providers who fraudulently bill the Medicaid program drive up the cost of health care for all of us,” said U.S. Attorney Daly. “The U.S. Attorney’s office is committed to working with our state counterparts to vigorously pursue health care providers that submit fraudulent claims to government health care programs.”
“Medicaid providers who choose to participate in the Connecticut Medical Assistance Program have a responsibility to ensure that they are in compliance with all applicable laws and regulations and are truthful when they submit claims for payment for services to the Medicaid program,” Attorney General Jepsen said. “We will continue to work to hold accountable those who seek to defraud our taxpayer-funded healthcare programs. I am grateful to our partners in this investigation, especially the U.S. Attorney’s Office for the District of Connecticut, the U.S. Department of Health and Human Services Office of Inspector General and Office of Investigations, the Connecticut Medicaid Fraud Control Unit and the Connecticut Department of Social Services Office of Quality Assurance, for their coordination and work in this case, and for the continued cooperation between agencies, both state and federal, as we work to protect our public healthcare programs.”
The allegations against Family Care VNA involve fraudulent billing to Medicaid for certain home health services. The services in question included 60-day assessments, billed pursuant to the Healthcare Common Procedure Coding System code S9123. According to the Healthcare Common Procedure Coding System, this service must be performed by a registered nurse.
It is alleged that Family Care VNA regularly billed S9123 codes when a registered nurse did not provide the assessments as required by Medicaid. Family Care VNA, with the knowledge and at the direction of its owners, regularly billed S9123 claims to Medicaid knowing a registered nurse had not performed the 60-day assessment as required by Medicaid. Additionally, it is alleged Family Care VNA, with the knowledge of its owners, submitted claims to Medicaid for patients who were or may have been dually eligible for Medicare and Medicaid, without first following required procedures for submitting claims to Medicare.
To settle allegations under the federal and state False Claims Acts, Family Care VNA, David Krett and Rita Krett have paid $5,253,908.54, which covers the time period from January 1, 2009 through April 30, 2016. Family Care, VNA, David Krett and Rita Krett also have entered into a Corporate Integrity Agreement with the Office of Inspector General for the U.S. Department of Health and Human Services.
This matter was investigated by Lawrence Marini, Forensic Fraud Examiner for the Connecticut Attorney General’s Office, with the assistance of the Connecticut Department of Social Services, and by the Office of Inspector General for the U.S. Department of Health and Human Services. The case was prosecuted by Assistant Attorney General Karla Turekian and Assistant Attorney General Antonia Conti of the Connecticut Office of the Attorney General, and by Assistant U.S. Attorney Anne F. Thidemann and Auditor Kevin Saunders of the U.S. Attorney’s Office.
U.S. Attorney Daly encouraged individuals who suspect health care fraud to report it by calling the Health Care Fraud Task Force at (203) 785-9270 or 1-800-HHS-TIPS.