Odyssey Whistleblowers Win $4.6M Lawsuit Settlement
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Odyssey Whistleblowers Win $4.6M Lawsuit Settlement

By Matt O'Donnell

 

Odyssey Healthcare(LEGAFI) -- Hospice provider Odyssey Healthcare, Inc. has been ordered to pay the federal government $25 million to resolve two qui tam whistleblower lawsuits accusing the company of submitting false claims to Medicare. More than $4.6 million of the settlement will go to two former employees who blew the whistle on the company.
 
According to the Odyssey Healthcare whistleblower lawsuits, the for-profit hospice chain submitted false claims to the Medicare Program for continuous home care services that were not provided in accordance with Medicare requirements. Continuous home care is only allowed during periods of crisis in which a Medicare beneficiary requires 24-hour nursing care to ease or manage acute medical symptoms.
 
This was allegedly done through a systematic practice of enrolling and re-certifying non-terminal patients, billing for continuous care when such care was neither reasonable nor necessary, and providing inadequate services and other violations of the Medicare Conditions of Participation, the whistleblower lawsuits claimed.
 
The lawsuits also alleged that Odyssey's actions were in direct violation of an agreement it signed in 2006 to resolve an earlier-settled qui tam lawsuit. Odyssey settled that Medicare fraud lawsuit for about $12.7 million.
 
The Odyssey whistleblower lawsuits were filed by two former employees of the hospice chain who observed the alleged Medicare violations first-hand. According to one of the whistleblowers, Odyssey's alleged billing schemes were provoked by an aggressive marketing plan that pushed sales reps to meet high monthly admission quotas. As a result, many Medicare beneficiaries were allegedly accepted into hospice with little documentation of a diagnosable or even terminal illness.
 
The Odyssey whistleblower lawsuits were brought under the False Claims Act, which allows private citizens with knowledge of fraud to sue on behalf of the federal government to assist in the recovery of the government's stolen healthcare money. If a whistleblower is successful, they can receive between 15 and 30 percent of the government's recovery. The Act also protects whistleblowers against retaliation.
 
Odyssey Healthcare will pay the federal government $25 million to settle the allegations raised in the qui tam whistleblower lawsuits. The whistleblowers will reportedly receive a collective $4,687,500 from the settlement amount.

 

Updated March 8th, 2012

All updates are located in the Qui Tam Whistleblower section of Legafi. 

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