DALLAS—Intrepid USA Inc., headquartered in Dallas, and various wholly-owned subsidiaries have agreed to pay $3.85 million to resolve the allegations that Intrepid violated the false claims act in connection with two lines of its business. The first allegation was that Intrepid knowingly submitted claims to Medicare for home health care services for patients who did not qualify for the Medicare home health care benefit or where services otherwise did not qualify for Medicare reimbursement. The second allegation was that Intrepid knowingly submitted claims to Medicare for patients who did not qualify for the hospice benefit. The settlement will be based on Intrepid’s ability to pay the resolution amount.
The U.S. Department of Justice (DOJ) alleged that between 2016 and 2021, 19 Intrepid home health care facilities submitted home health care benefit claims to Medicare for patients who did not qualify, were not properly eligible or where the services provided were not reasonable, medically necessary or provided by trained staff. Separately, the DOJ alleged that between 2016 and 2021, three Intrepid hospice facilities admitted patients to hospice care who were ineligible for the Medicare hospice benefit. These patients either were not terminally ill, or the Intrepid workers continued providing services when the patients should have been discharged after no longer meeting the requirements for the Medicare benefit.
“Medicare’s hospice and home health care benefits provide critical services to vulnerable patient populations across the country,” said Brian Boynton, principal deputy assistant attorney general and head of the Justice Department’s civil division. “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.”
“Businesses who engage in improper Medicare billing practices undercut the legitimate provision of health care services for patients in need,” said Andrew Luger, U.S. attorney for the district of Minnesota. “This settlement reinforces the importance of holding accountable health care providers who seek financial gain above quality patient care.”
“The Medicare program provides vital health insurance to the elderly and disabled population,” said Michael Bennet, U.S. attorney for the Western district of Kentucky. “Our office will vigorously pursue unscrupulous providers who choose to illegally and improperly bill the Medicare program.”
The civil settlement will resolve claims brought under the “qui tam” or whistleblower provisions of the false claims act in two different lawsuits. Under the provisions of the false claims act, a private party can file an action on behalf of the U.S. and receive a portion of any recovery. The investigation and resolution of these matters aims to emphasize the government’s commitment to combating health care fraud, the DOJ said.
“Home health is designed to increase health care access for our most vulnerable populations with mobility limitations, while hospice care aims to provide comfort and relief for the terminally ill,” said Tamala E. Miles, special agent in charge of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “Exploiting these systems for financial gain is intolerable. Working with our law enforcement partners, we will continue to pursue health care providers who jeopardize the integrity of these services by prioritizing profit over medically necessary palliative care.”
