American Senior Communities agrees to pay nearly $5.6 million to resolve false Medicare claims allegations

INDIANAPOLIS — The U.S. Department of Justice (DOJ) says American Senior Communities, L.L.C. (ASC) has agreed to pay $5,591,044.66 to resolve allegations that it violated the False Claims Act by submitting false claims to the Medicare program.

The claims are allegations only and there has been no determination of liability, according to the DOJ. ASC has denied all liability under the False Claims Act.

In 2017, a former employee of a hospice services company doing business with ASC filed a sealed civil complaint alleging ASC was charging Medicare directly for various therapy services provided to beneficiaries who had been placed on hospice, when those services should have already been covered by the beneficiaries’ Medicare hospice coverage.

Based on the investigation, the estimated loss to the Medicare program was $2,795,522.33 and ASC has agreed to pay $5,591,044.66 to the United States.

“Whistleblowers are critical to protecting public funds from fraud, waste, and abuse,” said U.S. Attorney Zachary A. Myers. “Health care providers who submit false claims or otherwise violate state and federal regulations when billing the United States Government will face consequences. Today’s settlement demonstrates that federal law enforcement agencies will vigorously investigate reports of false claims and seek to recover funds on behalf of the public.”

ASC released the following statement to WRTV Wednesday:

The Department of Health and Human Services – Office of the Inspector General did not uncover any evidence of injury or harm to patients because of the alleged conduct.