The U.S. Attorney’s Office for the Southern District of New York announced that it had settled a False Claims Act suit against Visiting Nurse Service:

[T]he United States has settled civil fraud claims under the False Claims Act against VISITING NURSE SERVICE OF NEW YORK, VNS CHOICE, and VNS CHOICE COMMUNITY CARE (collectively, “VNS”) related to the enrollment of ineligible members in the VNS Choice managed long-term care plan (“Choice MLTCP”). VNS improperly billed the Medicaid program for 1,740 members whose needs did not qualify for the managed care plan. These members were improperly referred by social adult day care centers (“SADCCs”), or received services primarily from SADCCs, many of which provided substandard and minimal care.

VNS agreed to pay nearly $35 million and has agreed to increase its vetting and oversight of community care organizations that  provide services to its members.

Read the full SDNY press release, “Manhattan U.S. Attorney Settles Civil Fraud Claims Against Visiting Nurse Service For Obtaining Millions In Medicaid Payments By Enrolling Ineligible Individuals In Its Managed Long-Term Care Plans And For Providing Substandard Services At Social Adult Day Care Centers”