The home health care industry frequently generates examples of serious fraud on the government. Work is performed inside private residences, often for clients who lack the ability to communicate regarding problems or are not aware that they are being used as part of a scheme to obtain payments for services that were not provided. Accordingly, employee whistleblowers play an extremely important function when a home health care company submits false claims. 

A qui tam case based on a report from an employee whistleblower has prompted a $600,000 payment to the government. Family First Home Health Care, Inc. of North Carolina paid that amount to settle an action brought under the federal and state False Claims Acts. Heather Coleman, who formerly worked with Family First, reported the misconduct and is entitled to a portion of the recovery.

Some of the specific allegations include the following: 

• Billing for services from daughter away at college — Some of the healthcare services charged to the government were purportedly provided by the daughter of Family First owner Marion James. However, during that timeframe, the daughter of Ms. James attended college several hours away where she was on the school’s basketball team, so she could not have done that work.

• Billing for services from worker who had moved away — Similarly, Family First also billed for services supposedly performed by an employee after they had moved out of the state.

• Billing for services performed by a family member — North Carolina Medicaid regulations prohibit payment for services provided by a family member. However, Family First submitted bills for situations where this occurred, but represented that the aide and the client were not related. 

Personal care services can make an extraordinary difference for someone who is elderly and/or suffering from a serious medical condition. Because of this, Medicaid and other government programs allow for the funding of home health care aides for those who qualify. However, providers that try to cheat the program drain resources from an already overburdened system.

Whether you work as a home health aide or in some other position where you have become aware of fraud against the government, you can pursue a qui tam payment like the one directed to Family First whistleblower Heather Coleman. Kardell Law Group can review the circumstances of your case and represent you in a whistleblower action.