Two Ohio Nurses Share a Reward for Blowing the Whistle on Medicare Fraud
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WASHINGTON, D.C. (July 19, 2024) — A national network of hospice providers agreed to pay more than $19.4 million to resolve claims that some of its facilities charged government insurance programs for providing services to patients who didn’t qualify for hospice coverage, the U.S. Department of Justice announced on July 17.
Federal prosecutors said they had reached the settlement with Gentiva, formerly known as Kindred at Home, after digging into wide-ranging allegations from more than 20 whistleblowers over a decade — including two Ohio hospice nurses represented by The Employment Law Group® law firm.
The nurses, Jason Medved and Anthony Donnadio, will receive a portion of the payout as their reward for alerting the government to alleged fraud at a Youngstown hospice via a lawsuit they filed in 2023 under the federal False Claims Act (FCA).
The FCA, signed into law by President Abraham Lincoln in 1863, makes it illegal to claim payment from the federal government via deception. The law includes a “qui tam” provision that allows whistleblowers to file a complaint on behalf of the U.S. and — if they prevail — to receive a portion of any resulting settlement or judgment.
In order to be reimbursed by taxpayer-funded programs such as Medicare, hospice facilities must claim payment only for patients whom a doctor expects to die within six months. But according to Mr. Medved, Mr. Donnadio, and the other whistleblowers, Kindred/Gentiva facilities pressured staff to admit patients who were “plainly ineligible” for hospice care — and who sometimes didn’t seem sick at all.
In their newly unsealed complaint, for instance, Mr. Medved and Mr. Donnadio listed multiple cases where patients were diagnosed with conditions such as late-stage Alzheimer’s disease, cirrhosis of the liver, or chronic obstructive pulmonary disease, all without having symptoms or laboratory results consistent with such diagnoses.
In one example in the complaint, a patient was admitted for chronic kidney disease. When Mr. Donnadio observed that the patient showed no signs of such kidney trouble, a doctor switched the diagnosis to late-stage Alzheimer’s disease — for which the patient also showed no symptoms, according to the complaint.
Besides defrauding the government, inappropriate hospice care can harm patients because it doesn’t include any treatment that’s intended to cure underlying conditions. According to the nurses’ FCA complaint, several patients left the Youngstown hospice after learning they weren’t fatally ill.
Gentiva denied the allegations but agreed to settle nine separate lawsuits, paying almost $19 million to the U.S. government, almost $450,000 to the state of Tennessee, and more than $23,600 to the state of Ohio. In all, the settled allegations spanned seven states and included both fraud and kickbacks.
About $2.13 million of total recovery was attributed to the Ohio claims pressed by Mr. Medved and Mr. Donnadio, both of whom resigned from the Youngstown facility, which operates under Gentiva’s SouthernCare Hospice Services brand.
“As registered nurses, Jason and Anthony owed a duty to their hospice patients first and foremost,” said Janel Quinn, a principal of The Employment Law Group. “They were advocates for ethical medicine, even when it wasn’t easy. This settlement is a fitting recognition of their professionalism and their bravery.”
Ms. Quinn represented Mr. Medved and Mr. Donnadio, along with TELG associate attorney Lydia A. Pappas and the firm’s managing principal, R. Scott Oswald. They worked on the case with Ann Lugbill and Nicolas Mendoza of Murphy Anderson PLLC, and in close cooperation with William E. Olson, a trial attorney at the Justice Department, and Assistant U.S. Attorneys W. Hunter West and Michael J.T. Downey at the U.S. Attorney’s Office for the Southern District of Ohio.
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Case Information
United States ex rel. Medved v. SouthernCare, Inc.
No. 2:23-cv-3345
U.S. District Court for the Southern District of Ohio
Complaint filed on October 10, 2023 (available here)
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About The Employment Law Group
The Employment Law Group® law firm represents whistleblowers and employees who stand up to wrongdoing in the workplace. Based in Washington, D.C., the firm takes cases nationwide.
