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January 12, 2024

DOJ Starts 2024 By Continuing Its Campaign Against Home Health Companies

On January 5, 2024, the Department of Justice (“DOJ”) announced an ability-to-pay False Claims Act settlement with Atlantic Home Health Care (“AHH”).  Continuing its long-standing emphasis on combating alleged fraud in the home health care industry, DOJ extracted nearly $10 million from AHH to resolve a multi-year False Claims Act investigation.

 AHH’s settlement has two components arising from two different procedural circumstances: (1) AHH allegedly submitted false claims to the U.S. Department of Labor (“DOL”) for in-home nursing and personal care that did not actually occur, which arose from a qui tam suit filed by a relator in May 2020; and (2) AHH allegedly paid cash bonuses of $500-$5,000 as part of a “friends and family” program to induce referrals in violation of the Anti-Kickback Statute, which AHH self-disclosed to the U.S. Department of Health and Human Services—Office of Inspector General (“HHS-OIG”) in October 2020 via the Self-Disclosure Protocol.  That self-disclosure was accepted by HHS-OIG; however, HHS-OIG’s review of the self-disclosure resulted in the discovery of another violation—that AHH allegedly paid for patients’ and potential patients’ expenses (including, but not limited to, food, internet, travel, utilities, medication, copayments, physician visits, medical treatments, safety improvements, and other equipment) in order to induce them to use AHH for home health care.  

While this is an ability-to-pay settlement (meaning the ultimate settlement amount was reduced based on AHH’s current financial health as attested by its sworn financial disclosures), AHH’s self-disclosure likely had a positive effect on the overall settlement amount since the announced $9,990,944.29 settlement amount reflects a multiplier of only 1.4 times the alleged actual loss to federal programs of $7,072,569. Since DOJ’s long-standing policy is that it will not settle for less than 1.5 times the actual loss even in the event of self-disclosure or outstanding cooperation, AHH’s settlement re-emphasizes the significance for companies of self-disclosure and cooperation when addressing potential False Claims Act violations.

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