Federal Judge OKs Provost Umphrey Medicare Whistleblower Case

Posted on Monday, October 3, 2016

U.S. government pressing claims of firm client in massive False Claims Act lawsuit

A federal judge in Nashville has ruled that a Medicare fraud lawsuit filed by a Provost Umphrey client on behalf of the United States under the federal False Claims Act can move forward despite an attempt to have the case dismissed by defendant SavaSeniorCare LLC, one of the largest health care providers in the U.S.

Chief Judge Kevin H. Sharp of the U.S. District Court for the Middle District of Tennessee issued the ruling Sept. 28 in a case brought by Provost Umphrey client Rita Hayward, a former employee of Atlanta-based Sava, and two additional whistleblowers whose cases were consolidated before Judge Sharp.

The original lawsuit was filed on Ms. Hayward’s behalf by Provost Umphrey’s Michael Hamilton, who has years of experience in False Claims Act cases working from the firm’s Nashville office.

The U.S. Department of Justice announced that it had intervened in the cases last year brought by Ms. Hayward and the other two plaintiffs who say Sava and its subsidiary companies knowingly and regularly submitted millions of dollars in false Medicare claims for therapy services that were unnecessary and not medically reasonable.

The government says Sava pressured its nursing homes to provide unnecessary and medically unreasonable rehabilitation services to meet unrealistic financial goals. The court order denying Sava’s motion to have the case thrown out says the allegations against the company are supported by the complaint, which specifically identifies 20 alleged false claims that are listed by patient, facility, Medicare claim number and other identifying details.

“Contrary to defendants’ belief, however, the consolidated complaint sets forth sufficient factual averments to suggest the claims are plausible, and pleads the alleged false statements with particularity,” the judge wrote.

As a result of the court’s recent ruling, the case will continue to proceed toward trial.

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