Odyssey HealthCare Settles for $25M Whistleblower Lawsuit Over Medicare Billing Fraud Allegations

Gentiva subsidiary Odyssey HealthCare will pay $25 million to settle a whistleblower lawsuit filed by one of its former nurses. The plaintiffs accused the hospice care company of enrolling patients that hadn’t received terminal diagnoses of six months or less to live to receive round-the-clock care.
In the Qui Tam complaint, Odyssey is accused of engaging in Medicare billing fraud between 2006 and 2009. One of the plaintiffs, registered nurse Jane Tuchalski, also filed a separate claim contending that she was fired because she complained about the company’s practices. That, too, has also been settled.
Gentiva Healthcare, also a hospice care provider, bought Odyssey in 2010. Under Medicare’s hospice benefits, only patients who are expected to die within a certain period of time are covered to receive 24-hour in-home nursing service. Continuous care is for patients undergoing an acute crisis with symptoms that can only be controlled with expert nursing care. The terminal diagnosis must be for no more than six months. The reimbursement rate for these types of services is the highest rate that a hospice can receive (up to several hundred dollars more a day than what is reimbursed for routine care).
Because more than whistleblower lawsuit was submitted against Odyssey for the alleged improper billing of continuous care services, all of the plaintiffs, who are former Odyssey employees are entitled to a percentage of the $25 million settlement. This means they will share about $4.6 million.
When Medicare billing fraud happens, it is the taxpayers who pay. Examples of this type of fraud include billing for medical services and goods that were never provided, as well as procedures and tests that were not required, double billing, up-coding, unbundling, and medical equipment fraud.
In order to combat Medicare fraud and other types of fraud against the US and the states, the Federal False Claims Act lets citizens act as whistleblowers to expose fraudulent behavior. Our whistleblower attorneys at The Gilbert Law Group know how intimidating it can be to out against your employer or another institution. However, by doing so you may be doing a great service. You also may be entitled to a portion of the settlement government obtains.
Also, you should know that if you are blowing the whistle on the company that you work for, the False Claims Act protects you from retaliation. In the event that action was taken against you because you exposed your employer, you are entitled to get back double the wages you lost from when you were let go or placed on leave.
Whistle-blower case on hospice fraud settled for $25 million, JS Online, March 1, 2012
Hospice Provider Odyssey Healthcare Agrees to Pay $25 Million to Resolve False Claims Act Allegations, Justice.gov, March 1, 2012
More Blog Posts:
Whistleblower Cases Result In Record $2.8B Recovery During Fiscal Year 2011, Product Liability Law Blog, December 23, 2011
Roche Settles Whistleblower Lawsuit for $20M, Product Liability Law Blog, December 19, 2011
Secret Whistleblower Played Key Role in Bank of New York Mellon Investigation, Product Liability Law Blog, October 31, 2011

The Gilbert Law Group® has a history of success investigating and litigating lawsuits against a number of the biggest companies in the world. Our Whistleblower Lawyers represent clients nationwide.

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