CareOne Management LLC agreed to pay $714,996 to resolve violations of the federal False Claims Act alleged by a whistleblower who earned $143,000 for exposing the company for cheating Medicare.
With over 68 centers in nine states, CareOne provides long-term nursing care and assisted living services, among other specialized care services.
Daniel E. Straus is chairman and CEO of Care One, New Jersey’s largest provider of nursing and assisted living facilities.
The allegations are that CareOne submitted false claims to Medicare for reimbursement of its “bad debts” without first attempting to bill a Medicare beneficiary to collect on the debt, as required by federal law.
According to the complaint, which was unsealed by the court, “CareOne undertook a post hoc effort to cover-up their lack of collection efforts by preparing false, ‘back-dated’ statements and collection letters that were never actually sent to Medicare beneficiaries.”
Many of these false collections statements never even included the recipients’ addresses, as they were never actually sent by CareOne. This was a complete ruse to justify the false cost reports seeking reimbursement [from Medicare] for non-allowable bad debt.”
Led by Charles J. Kocher and Matthew A. Luber, along with co-counsel Saltz Mongeluzzi & Bendesky, P.C, the law firm of McOmber McOmber & Luber represented a whistleblower client who filed this important False Claims Act case in 2017.
The allegations were originally made in a lawsuit filed by Margaret Gathman under the whistleblower provisions of the False Claims Act.
Gathman will receive $143,000 from the federal share of the settlement.
Under the qui tam provisions of the False Claims Act, a private citizen may serve as a whistleblower and bring a case on behalf of the government and share in a portion of any recovery.
In 2020, the federal government paid out $309 million to such individuals who exposed fraud and false claims by filing actions under the False Claims Act.
McOmber McOmber & Luber represents whistleblowers and investigates healthcare fraud under numerous government programs and industries, including Medicare/Medicaid, drug and medical device manufacturers, durable medical equipment suppliers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians.
This also includes the illegal payment of kickbacks to induce the prescription of drugs and the waiver or illegal subsidizing of co-pays for Medicare services and medications.
“If you have reason to believe your employer has violated the law, or you have knowledge that a false claim for payment may have been submitted to the government or a government contractor, McOmber McOmber & Luber can help you understand your rights and options,” said Kocher.
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