In April 2014, the United States Department of Justice and several whistleblowers reached an agreement with home healthcare provider Amedisys, Inc. to resolve civil fraud liabilities under the Federal False Claims Act (“FCA”) for $150 million. In addition to paying a $150 million civil settlement, Amedisys will be bound by a Corporate Integrity Agreement (CIA) with the Office of Inspector General of the United States Department of Health and Human Services (OIG-HHS). This settlement concluded multiple whistleblower suits, including one brought by Emily Lambert as co-lead counsel on the matter.
This settlement marked the successful conclusion of a nearly six-year effort by CAF Partners to expose fraudulent practices by Amedisys. While the case was filed in 2010, in fact, actions by one of the partners date back to September 2008 when, voluntarily, and out of a sense of duty, the individual placed a call to a regional office of the OIG-HHS. On that call, and over the course of a year of follow-up discussions with the government, the individual presented well-founded allegations regarding a systematic manipulation of data by Amedisys to make patients appear sicker than they actually were in order to justify extra, unnecessary therapy visits to qualify for bonus payments under the Medicare Home Health Prospective Payment System.