- CareAll Home Services, one of Tennessee's largest home health providers, will pay $25 million to the federal government and the state of Tennessee to resolve allegations that the company over-billed Medicare and charged for rendering services that were not medically necessary.
- The improper billing allegedly occurred between 2006 and 2013 and was uncovered by an independent audit paid for by CareAll. The company has been working with the government investigators for months, saying in a statement that "because of paperwork technicalities, the funds received for making certain home visits must be repaid."
- In a separate case settled in 2012, the company paid $9.4 million to resolve allegations that it submitted false cost reports to Medicare. The company made no admission of guilt in that case.
The regulatory crack-down on providers who draw on state and federal funds continues. According to Derrick Jackson, special agent in charge at HHS' Office of the Inspector General, this case is part a "surge across the country in fraudulent home-based services."
The case was initially brought by whistle-blower Toney Gonzales, who claims that he was demoted when he refused to participate in the fraud scheme. Gonzales will receive $3.9 million from the settlement.