| Federal suit targets a local business | | Posted: Tuesday, May 26, 2009 2:24 pm
| A Nashville businessman who operates a home health care agency in Martin is accused of defrauding Medicare for millions of dollars.
The U.S. Attorney filed a civil complaint May 19 against Jim Carell, the owner of Care-All Home Health organization.
Prosecutors claim Carell and another man, St. Louis attorney Robert Vining, masterminded a scheme to hide the true ownership of three home health agencies.
The charges cite the men wanted to receive ineligible Medicare reimbursements.
The charges look for reimbursement of more than $6.3 million plus three times that in damages.
The Martin branch is named in the suit with agencies located in Covington and Lebanon as well.
According to a press release filed by Ed Yarbrough, United States Attorney for the Middle District of Tennessee, the complaint alleges that, under Medicare rules, home health agencies were required to disclose if they were obtaining services from persons or entities that constituted ‘related parties.’ Related parties included persons or organizations that controlled the home health agency, according to the release.
According to the complaint, Carell and Vining have been friends since the 1980s and had an agreement that Vining would serve as the sham owner of the three home health agencies, while Carell and his company, Diversified, would serve as the management company.
The purpose of this arrangement was to evade Medicare rules, at that time, that limited a home health agency owner’s compensation, but placed no such limits on the fees of a management company.
The complaint also alleges that, if the related party relationship had been disclosed to Medicare, Medicare would not have reimbursed the agencies for the management fees at the levels charged.
The complaint alleges that there were numerous documents in which the agencies made false claims or fraudulent representations to Medicare, in which they concealed the related party’s relationships that they were required to disclose.
These false claims caused the Medicare Program to pay the agencies approximately $6,286,932 more than they were entitled to receive.
The United States seeks to recover three times this amount in damages plus penalties pursuant to the False Claims Act.
According to the release, this case is a result of an investigation conducted by the United States Department of Health and Human Services, Office of Inspector General.
The United States is represented by Assistant U.S. Attorney Ellen Bowden McIntyre. | | | | |
