Nursing Provider Settles Tennessee False Claims Lawsuit for $25 Million

Tennessee whistleblower lawyer for Medicare fraud lawsuit
Tennessee whistleblower lawyer for Medicare fraud lawsuit

FALSE CLAIMS ACT FREE CASE EVALUATION: 1-800-632-1404

CareAll, a leading provider of home-based healthcare and nursing services, has agreed to pay $25 million to settle a Tennessee false claims lawsuit. The Nashville-based company was accused of defrauding Medicare and Medicaid funds by “by submitting false and upcoded home healthcare billings.” Toney Gonzales, the qui tam relator, is expected to receive about $4 million for his efforts to highlight the fraud and false claim.

Gonzales’s TN false claim attorney accused CareAll of exaggerating “the severity of patients’ conditions to increase billings and billed for services that were not medically necessary and rendered to patients who were not homebound” between 2006 and 2013. Filed in a federal court for the Middle District of Tennessee, it was jointly pursued by the relator, U.S. Attorney’s Office, and the Tennessee Bureau of Investigation.

A whopping $23.1 billion have been recovered by the Justice Department from false claim litigations filed nationwide in the last five years. About $16 billion of the recovered amount involved false billing and misappropriation of health-care funds. The office of the U.S. Attorney General has made combating health-care fraud a priority, as more than $60 billion meant for patient care is lost every year due to “fraud, waste, and abuse.”

Tennessee False Claims Lawsuit: The Incentive for Whistleblower

The justice department has put its weight behind whistleblower lawsuits seeking criminal health-care fraud recoveries. This renewed interest has led to a nationwide upsurge with over 750 false claim lawsuits filed over Medicare fraud last year. In Tennessee, the impact has been massive with whistleblower lawyers and plaintiffs feel incentivized to participate in any such financial recovery. In September, a Tennessee whistleblower won $1.8 million as reward for his role in the recovery of $5 million. Meridian Surgical Partners, the defendant was accused of “misappropriating of $100 million through false billing.”

A whistleblower initiating a Tennessee false claim lawsuit stands to gain financial incentives, such as

  • reward of 15 to 25 percent of the total recovery from the defendant is awarded to the relator for his contribution in bringing to the notice the Medicare/Medicaid fraud when the state or federal authorities takes over the investigation and prosecution following his disclosure; or
  • reward of up to a third of total money recovered from the defendant is awarded to the qui tam plaintiff for highlighting the Medicare/Medicaid fraud and proceeding on his own with a Tennessee false claim attorney and without state or federal participation in the prosecution; and
  • a separate award by the court asking the defendant to pay for the legal expenses and fees of the attorney in addition to the money recovered.

The Ambit of Tennessee False Claims Medicare Law

Any type of fraudulent appropriation of healthcare funds, including false billing, phantom billing, misleading medical procedure, inadequate care, upcoding, double billing, fabrication of patient reports, and kick backs for referring, are punishable under the Tennessee Medicaid false claim act. Actions pertaining to falsification of records, conspiracy, avoidance of obligations, deliberate ignorance, and involvement in false claims with a intention to get monetary benefit also come under the legal purview of the act.

Any one, a whistleblower or a resident of the state with evidence to suggest fraud, can file a complaint with the authorities or file litigation with the aid and advice of a Tennessee false claims lawyer. However, a lawsuit claiming false claim in Tennessee must be initiated within three years of its discovery, subject to a 10-year statute of limitations.

For false claims free case evaluation and consultation with an expert Tennessee false claims attorney, please contact us or call on 1-800-632-1404.

Contact a Tennessee False Claims Act Attorney

We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.

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    Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.

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