Lawyers from Berg & Androphy’s Houston office were instrumental in a securing recent False Claims Act settlement along with the United States and the State of Texas regarding a health care services claim. Joel Androphy and Janis Gorton were retained by whistleblower Susan Anthony, the former marketing director of the Huntsville Health Care Center (HHCC) in Texas.
The case, filed on behalf of the U.S. and state, alleged that Health Services Management, Inc. (HSM) and HHCC billed Medicare and Texas Medicaid for services, which were not rendered or were so deficient and substandard that they harmed nursing home patients and were essentially worthless services. The settlement netted the Government and client more than $4.5 million.
Ms. Anthony alleged in a 2015 lawsuit that she witnessed patient abuse and neglect, including failure to bathe patients and change their clothes, patients not being taken to the bathroom and patients not being properly diagnosed and treated when they had infections. She alleged nursing home executives changed grievance reports to cover up mistreatment and hid other reports of patient complaints.
Ms. Anthony’s complaint detailed further ways in which HHCC allegedly failed to provide adequate care to the state’s neediest and most vulnerable patients, including basic hygiene, and nutritional services. According to the government, the investigation concluded that from Jan. 1, 2013, through Dec. 31, 2015, HHCC billed for services that were not provided or which were so substandard and deficient that they were considered worthless and potentially harmful to specific Huntsville patients. In addition to the $5 million settlement, the parties’ agreement requires HSM to enter into a Corporate Integrity Agreement with the Office of the Inspector General.
Ms. Anthony’s complaint against HSM also alleged retaliation, claiming she was mistreated on the job and eventually fired after she reported concerns about patient treatment at the Huntsville nursing home to executives at HSM. Androphy recently told Law360 that there will be a separate settlement of the retaliation claims.
“This was never about the money,” Androphy said. “Both of us were concerned about putting a stop to the issues that were going on at that facility.”
The case is United States and the State of Texas ex rel. Susan Anthony v. Health Services Management, Inc. and Huntsville Health Care Center, No. H-15-2291, in the United States District Court for the Southern District of Texas. Jill Venezia was the Assistant U.S. Attorney heading the investigation for the government.
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