A settlement has been reached to resolve False Claims Act allegations against Health Quest Systems Inc.
The allegations arose from a lawsuit that claimed Health Quest Systems Inc and certain of its subsidiaries Health Quest and Putnam Health Center (PHC) submitted inflated and otherwise ineligible claims for payment.
Reportedly, Health Quest Systems and Putnam Health Center acknowledged submitting improper claims for health-related services, including federally funded health care programs.
According to the government, allegedly, from April 1, 2009, through June 23, 2015, Health Quest submitted claims for evaluation and management services but did not sufficiently document the services to support the level of service billed. Allegedly, from April 1, 2011, through August 2014, Health Quest submitted claims for home health services that lacked sufficient medical records to support the claim. Allegedly, from March 1, 2014, through Dec. 31, 2014, Putnam Health Center submitted “allegedly false claims for inpatient and outpatient services referred to [the hospital] by two orthopedic physicians, in alleged violation of the Physician Self-Referral Law.
“This resolution is a testament to our deep commitment to protecting the integrity of federally- funded healthcare programs,” said Acting Assistant Attorney General Chad A. Readler for the Justice Department’s Civil Division. “We are determined to hold accountable healthcare providers that knowingly claim taxpayer funds to which they are not entitled.”
The settlement includes an additional payment of $895,427 that Health Quest will make to the state, which jointly funds New York’s Medicaid program.
In addition, Health Quest also agreed to enter into a Corporate Integrity Agreement with HHS-OIG to address future compliance.
The three whistleblowers, former employees of Health Quest, Tim Cleary will receive $1,893,092, John Betaudier and Carolyn Carroll will receive, collectively, $56,266, and Gregory Folta will receive at least $875,546 from the settlement.
