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DJO Law Group Team Takes Aim at Roswell Settlement in Light of False Claims Allegations

Two members of the DJO Whistleblower Law Group, Managing Partner, Daniel Ocasio and Christopher Piacentile, CFE, played key roles in the settlement by Georgia psychotherapy services to resolve false claims allegations.

A Roswell-based psychotherapy services provider, Carenow Services, LLC (along with its CEO) has agreed to resolve allegations of violating the False Claims Act. This was completed by billing Medicare and Medicaid for psychotherapy sessions at nursing homes that were either incorrectly documented, medically unnecessary, or billed at higher rates, which is a process known as ‘upcoding.’ The civil settlement was reached by Assistant U.S. Attorney Armen Adzhemyan, the civil Elder Justice Coordinator, and Georgia Assistant Attorney General Sara Vann.

The major counts of this fraudulent activity can be summarized as follows:

  • Between 2012 and 2018, Carenow billed Medicare and Medicaid for psychotherapy sessions at nursing homes/facilities that did not have any medical necessity.
  • Where the sessions were needed medically, Carenow upcoded these services and billed Medicare and Medicaid at higher rates.

Full details of the settlement can be found here.

This case is a prime example of how organizations can take advantage of existing programs like Medicare and Medicaid and use it to their financial benefit. These two members of the DJO Whistleblower Law Group played a key role in this case. Managing partner, Daniel Ocasio, worked tirelessly as part of the litigation team and Director of Investigations, Christopher Piacentile, was the originating and lead investigator. As stated by Chris himself, “Early on, it was quite evident that the fraud here was egregious when we discovered that the company was submitting bills for psychotherapy sessions for deceased patients. This provider would treat the chart, and not actually see or visit the patient before submitting their bill.” This settlement showcased the dedication and expertise that these two individuals bring to the DJO Whistleblower Law Group.

Daniel Ocasio, Christopher Piacentile, and the rest of the team would like to thank the U.S. Attorney’s Office for the Northern District of Georgia, the Georgia Medicaid Fraud Control Unit, and Health and Human Services—Office of the Inspector General, and the Federal Bureau of Investigations for their swift and complete closure of this case. Whistleblowers tend to receive between 15%-25% of the settlement once it is complete. Coming forward as a whistleblower in general is not an easy task, but it is an important one that can make a difference.

If you find yourself in a position where you witness fraudulent activity, reach out to our team here. We will provide a supportive, confidential environment to speak freely, and assist in holding organizations accountable.

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The DJO Law Group Takes Part in Important Downey Settlement Regarding Fraudulent Billing

The Dynamic Duo strikes again! Managing Partner, Daniel Ocasio and Christopher Piacentile, CFE, CFE, two members of the DJO Whistleblower Law Group and the originators of uncovering this industry wide fraud, have struck again. Fresh off the $40 million Apria settlement, this is now the second identical respiratory fraud settlement they have managed.

A Downey-based provider, SuperCare Health, Inc. has agreed to settle allegations that it took advantage of public health care programs through billing for ventilator services that weren’t medically reasonable or necessary. The whistleblower in this case, a respiratory therapist who worked for SuperCare, will receive substantial compensation for his part in exposing the corrupt practices enacted by the company. The main basis of the claim focuses on fraudulent billing practices.

The major counts of this criminal activity can be summarized as follows:

  • This settlement agreement was based out of two states: California and Nevada, where non-invasive ventilators (or NIVs) were provided by SuperCare and allegedly billed to public health programs when these NIVs were no longer needed or necessary. 
  • SuperCare then submitted, or caused others to submit, false claims to Medicare and Medicaid between May 2013 and October 2019 as a result.

Full details of the settlement can be found here.

This case is a prime example of how powerful whistleblowers are in enacting change and demanding justice. These two members of the DJO Whistleblower Law Group played an important role in this case. Managing partner, Daniel Ocasio, worked tirelessly as part of the litigation team, and Director of Investigations, Christopher Piacentile, was the originating and lead investigator. This settlement showcased the dedication and expertise that these two individuals bring to the DJO Whistleblower Law Group.

Daniel Ocasio, Christopher Piacentile, and the rest of the team would like to thank the brave individual who came forward to do the right thing and demand justice. Whistleblowers tend to receive between 15%-25% of the settlement once it is complete. Coming forward as a whistleblower is not an easy task, but it is an important one that can make a difference.

If you find yourself in a position where you witness fraudulent activity, reach out to our team here. We will provide a supportive, confidential environment to speak freely, and assist in holding organizations accountable.