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Chicago Healthcare Company and Its Former Owners Pay Nearly $2 Million to Settle False Claims Act Lawsuit (Chicago, IL) – A Chicago Healthcare Company and its former owners will pay nearly $2 million to the United States and the states of Illinois and Indiana to resolve a civil lawsuit arising from… Submitting false claims to Medicare and Medicaid.
The settlement resolves allegations that KareFirst Management, an independent nurse group, developed its own patient charting software and required nurse practitioners to use it, even though it knew it resulted in fraudulently coded claims being submitted and paid to Medicare and Medicaid. The lawsuit alleged that KareFirst contracted with nurse practitioners to see patients at skilled nursing facilities throughout the Chicago area. These nurse practitioners planned all patient visits using software developed by KareFirst. The software then generated false and cryptic claims that KareFirst submitted to Medicare and Medicaid for payment.
The settlement resolves a civil lawsuit filed in U.S. District Court in Chicago by a former KareFirst employee under the False Claims Act or whistleblower provisions. The False Claims Act allows private citizens to file lawsuits on behalf of the United States for false claims, and to share in any recovery. The United States intervened in the lawsuit before the settlement.
As part of the settlement agreement and consent order entered into Friday by Chief U.S. District Judge Rebecca R. Palmer, KareFirst and its former owners agreed to pay $1.99 million to Medicare and Medicaid over the next three years.
The settlement and consent judgment were announced by Maurice Pascual, Acting United States Attorney for the Northern District of Illinois, Mario Pinto, Special Agent in Charge of the Chicago Division of the U.S. Department of Health and Human Services, Office of Inspector General, and Robert W. “Wes” Wheeler, Jr., Agent Special in Charge of the FBI's Chicago Field Office. The government was represented by Assistant U.S. Attorney Sarah F. Terman.
The public is reminded that the civil allegations are accusations only, and there was no determination of liability as part of the settlement and consent judgment.
KareFirst Consent Judgment and Settlement Agreement
A Chicago health care company and its former owners are paying nearly $2 million to settle a False Claims Act lawsuit
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