The United States has settled a civil fraud lawsuit against Visiting Nurse Service of New York d/b/a VNS Health, Visiting Nurse Service of New York Home Care II d/b/a Visiting Nurse Service of New York Home Care, and VNS Health Behavioral Health, Inc. (collectively, “VNS”). VNS, which operates one of the largest non-profit home and community-based healthcare organizations in the US, is licensed by the New York State Office of Mental Health (“OMH”) to serve as an Assertive Community Treatment (“ACT”) Program provider. The settlement resolves claims that VNS violated the False Claims Act by fraudulently billing Medicaid for services that it either failed to provide or failed to document to persons with serious mental illness at the ACT Program VNS operated in Far Rockaway, Queens (the “VNS Far Rockaway ACT Program”).
Specifically, the settlement resolves claims that from January 1, 2014, through December 31, 2018, VNS submitted or caused to be submitted false claims to Medicaid for monthly payments for 103 patients at the VNS Far Rockaway ACT Program who did not receive the full array of services that VNS was required to provide under the ACT Program or for whom VNS did not adequately or timely document provision of such services in accordance with applicable regulations or the ACT guidelines. Under the settlement, VNS will pay the U.S. $381,766.59 and has admitted and accepted responsibility for conduct alleged in the US Complaint. VNS has also agreed to pay the State of New York $572,649.89 to resolve state law claims for a total combined recovery of $954,416.48.
