Vanguard Health Care and its subsidiary Vanguard Health Care Ancillary have agreed to a $2 million settlement with Tennessee and the federal government following alleged Medicare billing fraud.
The U.S. Attorney’s Office in Nashville as well as Tennessee officials claimed Vanguard violated provisions of the False Claim Act for billing to Medicare services and supplies to nursing home patients for which it had also billed the state’s Medicaid program.
The settlement, announced in a press release Tuesday by the U.S. Attorney’s Office for the Middle District of Tennessee, resolves any claims made by the U.S. government as well as the state.
Authorities also claimed Vanguard wrongly billed Medicare for enteral feeding supplies that it had received for free and then billed Medicare for patients who were not eligible for the skilled nursing in-patient benefit.
According to the settlement, Vanguard agreed to pay nearly $1.9 million to the United States and $119,380 to Tennessee. The company also agreed to a comprehensive Corporate Integrity Agreement with the federal Department of Health and Human Services.
The investigation and resolution was handled in part by the Health Care Fraud Prevention and Enforcement Action Team initiative, announced in May 2009 by Attorney General Eric Holder and Kathleen Sebelius, secretary of the Department of Health and Human Services.
Assistant U.S. Attorney Lisa Rivera and United States Department of Justice attorney Jill Callahan represented the United States.