Nashville home health provider is second to make news this week over billing practices

3:19 PM, Aug 11, 2012   |    comments
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Written by
Anita Wadhwani
The Tennessean

Nashville-based Careall Management - one of the largest home health-care providers in Tennessee - has agreed to pay the federal government $9.375 million to settle claims it falsely billed Medicare.

The settlement, announced Friday, is among the top five settlements in Middle Tennessee in the past five years for violations under the False Claims Act, said Department of Justice spokeswoman Ellen Bowden McIntyre. The act makes it a crime to falsely bill the federal government.

The settlement comes amid heightened scrutiny of the health-care billing practices by hospitals and other health-care providers by the federal government. There have been other key players in Nashville's signature industry currently under investigation for their billing practices, including Vanguard Health Systems, Community Health Systems, LifePoint Hospitals and most recently HCA.

The settlement brings to an end a three-year investigation into Careall, its chief executive and its affiliate entities on allegations they engaged in a complicated scheme to overbill the Medicare program for more than $6 million in management fees. Friday's agreement with federal investigators allows the company to continue to serve as a Medicare provider.

"The false reporting scheme alleged in this case robbed the Medicare Trust Fund of millions of taxpayer dollars," said Stuart Delery, acting assistant attorney general for the civil division of the Department of Justice. "Settlements like this one make sure that our federal health-care dollars are spent appropriately - on maintaining critical health-care programs."

The agreement includes no admission of guilt by Careall Management. On Friday, owner James Carell said he did not violate the law but agreed to a settlement to put the case behind him.

"I'm 76 years old, and I settled with them because I need to get it over with and get on with life," Carell said. "It makes the papers tomorrow, and then (it) will be over with. We settled, and that's it

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