VNSNY Agrees to $57 Million Settlement

The Visiting Nurse Service of New York (VNSNY) has agreed to pay $57 million to settle a whistleblower lawsuit that alleged it billed the Medicare and Medicaid programs for hundreds of millions of dollars in home care visits that were not actually provided. The lawsuit, originally filed in 2014 by a former executive of VNSNY, claimed that the agency routinely accepted more patients than it had the capacity to treat and did not inform referring physicians when patients’ care deviated from their care plans.

VNSNY did not admit wrongdoing, blaming the disparities on patients’ refusing to accept care on particular days, and on record-keeping issues. The settlement, the largest ever by a nonprofit home care agency, will be split roughly $50 million to the federal government and $7 million to New York State. The whistleblower will receive an undisclosed share of the proceeds.

The National Association for Home Care and Hospice submitted a brief to the court and issued a statement supporting VNSNY, pointing out that Medicare does not require strict adherence to plans of care. If the practice of revising care plans without notifying referring physicians is commonplace, as suggested, more False Claims Act lawsuits and settlements with home health agencies may be on the horizon.