A nationwide home healthcare and hospice provider will pay $3.85 million to resolve False Claims Act allegations, it was announced by the U.S Department of Justice (DOJ), as well as the U.S. Attorney’s offices in the Western District of Kentucky and District of Minnesota.

According to the DOJ, Intrepid U.S.A. Inc., headquartered in Dallas, and various wholly-owned subsidiaries (Intrepid) have agreed to pay $3,850,000 to resolve allegations that Intrepid violated the False Claims Act in connection with two lines of its business: first, that Intrepid knowingly submitted claims to Medicare for home healthcare services for patients who did not qualify for the Medicare home healthcare benefit or where services otherwise did not qualify for Medicare reimbursement; and second, that Intrepid knowingly submitted claims to Medicare for patients who did not qualify for the hospice benefit. The settlement is based on Intrepid’s ability to pay.

The United States alleged that, between 2016 and 2021, 19 Intrepid home healthcare facilities submitted claims to Medicare for home healthcare services for patients who did not qualify or were not properly certified as eligible for the Medicare home healthcare benefit, where the services provided were not reasonable or medically necessary, where the services were provided by untrained staff, or where services were not performed.

Separately, the United States alleged that, between 2016 and 2021, three Intrepid hospice facilities admitted patients to hospice care who were ineligible for the Medicare hospice benefit because they were not terminally ill or continued providing services to patients who should have been discharged because they no longer met the requirements for the Medicare hospice benefit.

“The Medicare Program provides vital health insurance to the elderly and disabled population,” said U.S. Attorney Michael A. Bennett for the Western District of Kentucky. “Our office will vigorously pursue unscrupulous providers who choose to illegally and improperly bill the Medicare Program.”

Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division, stated, “Medicare’s hospice and home healthcare benefits provide critical services to vulnerable patient populations across the country. This settlement reflects our commitment to ensuring that these benefits are used to care for those who need them and not just to enrich those who seek to provide them.”

Three whistleblowers brought the actions, and each of them will receive over $300,000 from the recovery, as a result.