April 26, 2007
The U.S. Dept. of Justice announced on April 26, 2007 that it has intervened in three qui tam suits accusing HealthEssentials Solutions Inc. (HES) of false claims billings to Medicare. HES is accused of upcoding, improperly assigning a diagnosis code to a patient discharge that is not supported by the medical record for the purpose of obtaining a higher level of reimbursement.
HES, a provider of geriatric care, is also accused of knowingly charging Medicare for medically unnecessary services.
Former employees of HES filed three separate suits under the whistleblower provisions of the False Claims Act.