For-profit home health provider Carter Healthcare LLC, along with its affiliates CHC Holdings and Carter-Florida (collectively Carter Healthcare), their President Stanley Carter and Chief Operations Officer Bradley Carter will pay $7.175 million to settle allegations that they violated the False Claims Act by overbilling the Medicare program. The settlement resolves allegations filed in qui tam, or whistleblower, lawsuits by Sharon Mahaffey and Mark Brimer, both therapists who were formerly employed by Carter Healthcare.
The qui tam provisions of the False Claims Act enable private citizens to file lawsuits on behalf of the government if they know of an individual or company defrauding the government. Qui tam whistleblowers are eligible to receive between 15 and 30% of the government’s recovery, if one occurs. According to the U.S. Department of Justice (DOJ) press release, Mahaffey and Brimer will jointly receive $1.3 million of the settlement.
Allegedly, between 2014 and 2016 Carter Healthcare “billed the Medicare Program knowingly and improperly for home healthcare to patients in Florida based on therapy provided without regard to medical necessity and overbilled for therapy by upcoding patients’ diagnoses.” For the settlement, “Bradley Carter will pay $175,000, Stanley Carter will pay $75,000, and Carter Healthcare will pay the remaining $6.925 million.”