Nashville-Based Friendship Home Healthcare And Related Companies Pay U.S. And Tennessee $6.5 Million To Resolve False Claims Act Lawsuit

A group of home health care companies collectively known as “Friendship” and the companies’ owner Theophilus Egbujor paid $6.5 million, plus interest, to resolve allegations that they improperly billed TennCare, Medicare and TRICARE for home health services, announced David Rivera, United States Attorney for the Middle District of Tennessee.  Friendship and its owner also agreed to be bound by the terms of a Corporate Integrity Agreement with the Department of Health and Human Services-Office of Inspector General (HHS-OIG) in an effort to avoid future fraud and compliance failures.

“As this case demonstrates, enforcing the False Claims Act remains a key priority of the U.S. Attorney’s Office for the Middle District of Tennessee,” said United States Attorney Rivera.  “The U.S. Attorney’s Office and our law enforcement partners will continue to vigorously pursue those who knowingly submit false claims to government health care programs.”

“We are pleased to be part of this coordinated effort to protect taxpayer dollars,” said Tennessee Attorney General Herbert H. Slatery III.  “Preventing and prosecuting fraud in our government healthcare programs not only is a deterrent to those looking to take advantage of the system but also sees that much needed healthcare dollars are used as they are intended to be used.”

The settlement resolves the government’s claims that Friendship submitted false claims to TennCare, Medicare and TRICARE during the period of July 2007 through July 2013.  The government asserted that Friendship billed TennCare for private duty nursing services that were furnished or supervised by a woman who was excluded from billing federal and state health care programs and that Friendship submitted required forms to TennCare that contained the forged signature of Friendship’s Director of Nursing.  The government also contended that Friendship improperly billed TennCare services without the required forms and signatures.  In addition, the government claimed that Friendship failed to repay TennCare within 60 days of learning that Friendship had wrongly billed for care provided by a woman whose nursing license had lapsed.

The specific entities included in the settlement agreement are:

• Friendship Home Healthcare, Inc., which has also done business as Friendship HealthCare System,
• Friendship Home Health, Inc., and Angel Private Duty and Home Health, which have also done business as Friendship Private Duty, and
• Friendship Home Health Agency, LLC.

Under the settlement agreement, Friendship and Egbujor paid a total of $6,500,000, plus interest.Of that amount, $4,025,573 goes to the United States, and $2,474,427 goes to the State of Tennessee.

“Fraud involving home health services is a major problem impacting the Medicare and TennCare programs,” said Derrick L. Jackson, the Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General in Atlanta.  “Patients are particularly vulnerable to fraud in a home-based setting because there is often no one looking over the provider’s shoulder.  This case demonstrates there are serious consequences to home health agencies that try to defraud federal health care programs.”

The allegations resolved by today’s settlement were originally raised in a lawsuit filed against the Friendship companies and Egbujor by Kay Flippo, a licensed practical nurse who previously worked for Friendship Home Healthcare.She brought her claims under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private citizens with knowledge of false claims to bring civil suits on behalf of the government and to share in any recovery.Flippo’s share of the settlement has not been determined.

The case was handled by the United States’ Attorney’s Office for the Middle District of Tennessee and the Tennessee Attorney General’s Office and investigated by HHS-OIG, the Tennessee Bureau of Investigation Medicaid Fraud Control Unit (TBI MFCU), and the Defense Criminal Investigative Service.  Assistant U.S. Attorney Ellen Bowden McIntyre represented the United States.  Tennessee Assistant Attorney General Mary McCullohs represented the State of Tennessee.

The case is docketed as United States ex rel. Flippo v. Friendship Home Healthcare, Inc., et al., No. 3:14-cv-1262 (M.D. Tenn.).  The claims settled by this agreement are allegations only, and there has been no determination of liability.