INDIANAPOLIS – American Senior Communities, L.L.C. (ASC), a provider of skilled nursing and long-term care services throughout Indiana, 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.

In 2017, a former employee of a hospice services company doing business with ASC filed a sealed civil complaint or “whistleblower” lawsuit under the False Claims Act in the United States District Court for the Southern District of Indiana. The complaint alleged that ASC had engaged in conduct to defraud the Medicare program. Specifically, the complaint alleged that 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.

The False Claims Act provides that when a whistleblower files a lawsuit alleging fraud that results in a recovery of funds by the Government they are entitled to between 15 and 25% of the recovery. This whistleblower provision of the law encourages people to come forward when they believe fraud is being committed. Under the False Claims Act, the Government may collect up to three times the loss it incurred, plus a fine of between approximately $5,500 to $22,000 for each false bill submitted.

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

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