INDIANAPOLIS — American Senior Communities, an Indiana nursing and long-term care services provider, agreed to pay more than $5.5 million to resolve allegations that it submitted false claims to the Medicare program, the U.S. Attorney's Office for the Southern District of Indiana announced Wednesday.
In 2017, a former employee of a hospices services company, which was in business with ASC, filed a sealed civil complaint, or "whistleblower" lawsuit, under the False Claims Act in the United States District Court for the Southern District of Indiana.
The complaint alleged that ASC had "engaged in conduct to defraud the Medicare program" by charging Medicare directly for various therapy services provided to beneficiaries who had been placed on hospice when those services should already have been covered by the beneficiaries' Medicare hospice coverage.
An investigation revealed an estimated loss to the Medicare program of nearly $2.8 million, and ASC has agreed to pay over $5.5 million to the United States.
Under the False Claims Act, the government may collect up to three times the loss it incurred, plus a fine of between approximately $5,500 to $22,000 for each false bill submitted.
Under the terms of the agreement, ASC denied all liability under the False Claims Act.
In their investigation, the Indiana Department of Health and Human Services – Office of the Inspector General did not uncover any evidence of injury or harm to patients as a result of the alleged conduct.