Allegations of False Claims Billings to Medicare Snags HealthEssentials Solutions

The United States has intervened in three whistelblower false claims actions involving HealthEssentials Solutions (HES), a Kentucky-based provider of geriatric care. The company’s nurse practitioners provided services to beneficiaries in nursing homes, assisted living facilities and private homes.  HES had to select on its Medicare claim forms the level of service and location where the service was provided. The accusations specifically claim upcoding by HES to obtain a higher reimbursement from Medicare.  Further, it is alleged that HES charged Medicare for unnecessary services. “The government’s intervention in this case demonstrates the Department’s continued commitment to stamp out fraudulent practices that threaten the integrity of the Medicare Trust Fund,” said Assistant Attorney General Peter D. Keisler, of the Department of Justice’s Civil Division.

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