A recent article published by the New York Times reports that a whistleblower lawsuit has been brought against Visiting Nurse Service of New York for allegedly extracting hundreds of millions of dollars from Medicaid and Medicare through falsified billings and inadequately providing doctor-ordered care to patients. The suit was brought by a senior manager who worked for Visiting Nurse Service for more than 16 years.
The lawsuit states that beyond this large financial fraud, tens of thousands of disabled, impoverished, and elderly residents have been victimized by the V.N.S.N.Y.’s misconduct and have not received the critical home health care services they need.
Originally, the lawsuit was filed under seal in the United States District Court for the Southern District of New York in 2014, which prompted a private investigation by state and federal authorities, who allowed the amended complaint to be unsealed as of last week. For now, prosecutors have declined to join the case but reserve the right to intervene at a later date.
Currently, the complaint alleges:
- The Agency ignored care plans prescribed by physicians, providing only a portion of rehabilitation and nursing visits, ordered under Medicare. This malpractice threatened the welfare of patients, lawsuit charges, and resulted in unnecessary rehospitalizations.
- Hundreds of nurses and therapists of the agency falsified service and time records. According to the suit, the Visiting Nurse Service’s home-care visit tracking reports show an impossible amount of visits and visits too short to provide patients with adequate care, all without required verifications that these visits actually took place.
- The agency has regularly billed the government for home care services that were improperly supervised or never provided. In addition, the suit states that the agency has double-billed the government when patients were eligible for both Medicaid and Medicare.
To learn more about the case, read the New York Times article here.
Believe You Have a Whistleblower Case? Call Freidin Brown, P.C.
Each year, Medicare and Medicaid programs account for large amounts of spending. As healthcare costs continue to rise, the time and resources consumed by processing claims and making payments leave little time to verify claims. For this reason, government agencies often pay claims without the time to investigate them for fraud. If you are aware of fraudulent claims, you may be able to file a whistleblower suit under the False Claims Act, and our team at Freidin Brown, P.C. can help you do so.
To discuss your case, get in touch with our Miami whistleblower lawyers at Freidin Brown, P.C.