Complaint - 2017-091-C

1.2 MB·English

by  Office of the Attorney General - Georgia

INTHE CNITED STATES DISTRICT COURT
FOR THE SOUTIIBRN DISTRICT OF GEORGI

SAVANNAH DIV

LNUKED STATES OF SMFRICA ex
rel. JOLIE JOHNSON and DEBBIE
THELMILY

and
STATE OF GEORGIA ex rel. JOLIE
UOUNSON and DEBBIE ITRLMLY,

Plaintiit Relators,

BETHANY HOSPICE OF COSBTAL,
ORORGIA, LLC, BETHANY
HOSPICE, LLC, BETHANY
BEREVOLENCE FUND, ING. AVA
BEST, THOMAS MILLER, M.D.
AUSTIN TARRELL., M.D., DAVID
ARNE, M.D. STAN SINGLALR,
MD., RICHARD K. WHEELER, MD.,
BERKLEY M. “MAC” MACKEY, ST.
JOSEPHS - CANDLER HEALTH
SYSTEM, INC. JOENIE ALMEIDA,
M.D. BRIAK ANDERSON. M.D.
MEMORIAL HEALTH, INC,
MEMORIAL HEALTH UNIVERSITY,
MUEDICAL CENTER, INC..
PROVIDENT HEALTH SERVICES,
INC, MPPGINC., MEMORIAL
UKALLH UNIVERSITS

PHYSICIANS, (.1.C, COMMUNITY
HOSPICE HOLDINGS, LLC,
SOUVRERN COMMUNITY
HOSPICE CARE, INC., SOUTHERN
COMMUNITY HOSPICE, INC.
VICKI RYLES, ROYCE IWLE:
JASON COLBERT, JAMES L. BAY,
M.D. PATRICK BYRNE, M.D.
MISTY POOLE, MD, HOSPIOR
SAVANNAI, INC. THE STEWARD
CENTER FOR PALLIATIVE CARE,

‘SION

Civil Section Ne.

Jury Fria] Demanded

BILD ONDER SEAL.
INC, HOSLICE SAVANNAU
FOUNDATION, INC, MONICA
ANDERSON, BRUCE BARRAGAN
CHAD CARNELL, KELLY EROLA,
MLD. LAURA PARLESS. 4.0,
MARTIN GREENBERG, MD.,
DEBRA ANTHONY LARSON,
APPLING HEALTHCARE SYSTEM.
INC, COMFORT CARE HOSPICE,
ULC, RAY LRANRETTER, ANGIE,
POTTS, ERROL GRARAM, MD.,
SOUTMCOAST WRALTH S¥STI
SOLTHCOAST MEDICAL
ASSOCIATES, LLG, SOUTHCOAST
MEDICAL GROUP. LLG,
THEODORE GEFFEN. W.D.,
THOMAS MORTARITY, WD.
PRUUPTHEATIL, ING. PRUETT
HEALTH HOSPICE, INC., NEIL
PRUETT JR

a

Defendants

COMPLAINT

he Latled Suter ef Aimeriea and the Sate nT Ceoegia, Ry ad songh Relators Jeu

Iahavsv and Neh Fe'raly, ing Cs aston wales 9 ULS.C, 86 SPP8SPL PY aa Cis era

see CUA, ¢ AYE 166.1 ef seq. (Georgia exe Mecived Calms 86) 4a move: ah

etcages, pocactes, ad cches veaec.esesabliched 45 che Ke.s¢ Clatsns Acton hehe Tal the Loitee
Stsses ard Keleross. andthe State False Meshesid Cans Accu aebalft the Stats ef Cesar ame

satess, and wovld stew tae Plow

1 ANFRODLCHION

1. se:e is & age Ispioe protien °u Southere Cidorgia, Peomaily spice

companies bave d'seoyered tha they car uanipwlete the sysiun tro. gh hiekbaks ane adnesning,
paticars who da not quslty. “They aa

é:srupted che erie poi of y

progien

Souham Georgia, This ee

Wn stop. This esl fs inlerded ve change the tend of Fesp.ce

‘caf hemsesl walnsreblein Ge systert, Th

weparies pre Hing em a definate hive emgage

fn Medicare fra. teraugh spuostiog, deub'e Wing. aeitiny il yMle patie

‘euichaey ane
hile hes ef other improper act ves

2 As uresull ei this exnduct, Meter

fare tile ender the Pulse Clems Al, 3

USC. 8.5729, a ey. and toe Ges Feive Vedivad Cams fet, 0.03.4,

168.0 se

Ul. TURISDICTION AVP VENUE

5 ‘Unis secsmavices usdes she Kalse Clatane At, 3: UST. 8H

False Moses

ns ACL OCGA. p49 4 IER, er sca

1 This cover

«personel tpasdlsies. ovec far Defesércrs po as

USCS

aad

fre hat Defencents five “his jumistenien, eo semsnet latrines it this jevledi.oe,

ons. af the vinations ofthe Palse Cla'ms Act Tass~'hed herein were santed get in his dita

.Wis Cuurt her aubjecsmatisr unsdietim over this wan prrsiart to SC. §§

1334 end [345 and 31 WSO, § 37528} ane)

5. Veawe is prover it chis district unde

and (0) ec acer
USE SEMEL OMO.CGA $284 1086.

uh, ‘THE Pads:

7 Defsnisut Bechany Hespive of Censtal Grecia, LC ane Betzany Uses, Lt
see prowidars of espies gate Seehumy Ans four locators ir Geeagin wk offess 1a Claatoe
Dawes: josia, andl Qviamer, Ths Douuls edive isloseied at 201 Westade Dsive, Douglas,

Geengie, £1542 Te Qitmen offi is incsted a: 190 Wost

cea Sweet, ILO. Hoss £087,

Quin ir, Georgie, 160%. ‘Ike Valénsta one ig lacareal ot 7 AM Donte es Steet, Bue
cesta, Georgia, £160! Dekendan" ctkany Benenlesse Fund, Ine, ja oeated at 2706 N. Cavs

Stecer, Bevtiieg NL, Va'dosra Georgia 31602. Telindact Ave Host as the Premdsnt of

Those Mie BLD. isthe Bet Sa

say Medical Directo ac

Tatany, Rete beatin

Delendumt Just Hazell, M1. is ths Detharey Mesheal Drevin as leestion and 2

au eniplover of Cofve Regional ‘Toepital. iebeuca! Stan Sanclow, M2 ond Detersiea Davis

chara

Arne, MLD aie “he Bethany Medios! Direct =

Coffe Reginsel Heise, Detengane
1 Wheeler, MD. ss tie Bethany Modieal Dover sctie We.dosta late: aud Beiendant Berkey

of Mae a5 ae Chief Huanctal

ect as "Bethy"

8, Defradant St Josoph’s'Canales Health System, kee ave co hospitals providing

inpatient oupatient ma encygensy eave arl consists ol Thee sae can, Uke S Josega'e

‘Sone Foeztion sZncate at 1195 Mine Reievard, Savant 22'S The Caller

Hospital is a W-hed Foeify and Thesis i Sevunsiais midtown, Deloria Jeni: Alma

MA. i cx ite.zsl imedicuwe yysician employed uy St. Joceph'sUandle: locetee at 5

biscuhowe Dave, Severza., Goo1g.a, Ls, Almeida is alse tLe Medical cera at Spanish ahs

strarRegpice and Tara Nasing Home so Defends! Brom Ardscon, 0D. is physier sho

semently vee #5 Soarh Sacaliew ba seirks “or Si Teasgh Camels Galery wens *9 a8

“$. cge'siCan€ er")

D. Belentsnt Vemvrsl Hash, Ine. ghe Hoidiry Company’) is # monroe

ferponancn ergamies] oh this Tees whe Shute a Chenin une tieatiine & seine eZee

fdines of 4799 Wess Aveae, Suessre’, Grovgin “208, The aiding Company vias ciestnd

ws ard gerne a eompachersive Swalth sire oyster exmeiling a ea

ant inpaiont

crea’ “ee¥ ines, physioisn practinos, navdeney Imaching progricis mui nawancatien ar
cohts slated ara aneillzey eeanponeacs, “The Hett.ag Compicy ews and eperates Devendant

Men

“Teeth Univeasisy Mochaal Jerior. Ins, (Meera) and is a sicepiatit causation,

organicnds Wade lass of he Ste's ef Cooryia and “naira: © yeineipas efive adevese 92 70

‘Waters Avene, Se we educa

16h, Georgie SHIH. Mamas! operates a

ruulpe evan a ma, Jetandass Shovsces:

Servives, nc. Provide

Jig forgpri i compenatvn oraae ead des tela ef the Stste

sud ecsintalos @ prin eee a uh Weta

suas. SVR

ra, Goargia

21404. Srowrdort se a zoeting campy fen vans ne tke anc Hayy senee sreviéer

sting
ecuusetan wrk ye Heepied Seludiny ambuhewe caanspoc. anil office billings, ant

igsicians employs by Delian MOD, Ine, Mesnaisa a sae at.3 more: of Provides

MHC, one fee repr ex

ratiocs eugesrod wndky the Tass eF the Sous of Goong: an

assitteing = pecetpal eThce afuress of 13

6 Weters avvesse, Savanna Ceuryie 31824, SHLP

cove, passes nde ‘name. Mesnsris Meith Trt versigy Pheckas. MPG is toe

‘or bese pests wer

pal eaty

Memoria: Heatts Lanes.ty Physinrsee, LLC meting

2 pumcpal sfdrese oF APOE Wates Avenue S

weaaeh, Garrg’a ADAM Dafereanrs Respien

Savernwa, Jae. The Sissoutd Cer tet “in Paluatve Cace, Ine asd Hospice Sevarnah Toandar’gn

Jos, ms providers el huspive eure aud yiiative sace wil chs oetneipal ole Teeatal a! “87

Chad Parowuy, Susannah, Geosg:a, 31M This Iecat en, fe the matin lier fiw the Femecare

end almisistr “Toupee Sawaal. serves fee

sivgenrem Geonsia

Coettem,

ingharr, Inert ane cue, hs Heepise Hose, wich spat of Hoagie

ve fhe! inpaent faliy foe patients wots mara) aseees that canna. he Farle Toone ane

iy locate af 182 Tiserdve: Deve, Samana, Go

£9. 3.406 The Derere Conte
-sTaeided at ote Brnacss Cente Drive, Savaiwah, Geet

rowndaon, foe, BUI Gisele fs Caster br [2ucation & Gurcé Shpzor, “he Stewie

Cua tor Bal tative Cart, ancl te Edo Caregiver Poaftate, Usfeaoant Kelly

ia, MD is or

serashand

tie etaff.at Morserin snd is Medical Dizerzerat Mospce 8 is inetigsof he peel

bate seogan: at Foxpive Savezoa “Tee Seewanl Gewas.” Defesenmt Vonies Aveo is the

Coatd Gigi Oifase: Deteudear Bonen Tamagan the Chair Hospiue Savana od of

Ieceerers; Defends Ube Ces ellis the Chief Opersume Otfiees: Defendant Fauna Panless, 4.0.

1 Ge Balllive Care Physics, Defisdan: Martin Cezuborg, 62 a6 the Chair af The Stewed

Garter ie Palliative Caze, ine, Sean! af Mrecers, soe Defendant De

Author y Lars se

»

sith, CHO ed COM of Hosyice Sevecsah. tor faiclnuiively referred

Moss

HO. Defentents applies Neat fit

ar Teas Appin) Ss & neeasee, em

cule cate 6

acute sare moe.sal feliny. Aprls. = .censod Fe 6, 18 gaviewie

beds, {01 SNF bed, aretha d eval hentieGivfes, Apovng

ai 20-810 ene aeplayees

re ys luted at 185 5, Vo:son Ses Dy 2, Dafersen! angling is rovscnee

lo the Banlev-Anpling Commty Shnopital Beard Actsorig. Dafendamts Cerliet Care Ue

ice

nd aie aac te

OCCT are ovens of hnapice care theacah COH's parmensip th Appling

provile servioes soca? vie CC. located a 88

se Pee Appligs Hah Cns Sy

Teriuize Steet, Baxley, Ceargin 21513, Deikasent Kay’ Toacbeneris te ietuue. CLO of Appl

Hexlih(are Systern ag of Wars’ 2016, Dete

iv Petts, BV is eek awres ef CCH, Ms

Pars opened 2s Zespiss kense.in the Ayysla Comty Hospital, which 2 else anon: as fasting

TeattaCare System, Deforstos: rel G3

sm, MD. ia ptysiciun for Carrfor: Cae (eeieetve:

referred to hescan 2 "Coraler Cs
i Deltas Si

whem Come enity Kosice Case, den Co

sypagity Hospice

Hidings: LC aud Seensnry Caran aniy Moyave, Jae, sen pravieers of spine care, Community

Tinspice apened 1999 ard Wes tse> Covalent Gee.

wich cemist at ei

(Covmrons Lo

fo 9D VI, Veron Rial

pn Pei prin off lev

ss, Geviata

pan.

any Wick Byles is che Cetonuderand 2areskemt of Coer-anity Toegive, Ms. Re

ie alen 2 Xeqpstered Nose Tis"er Cant Rese Aves

Je Cosford Chie Vinanenel (ices

We Conucsnige Koasee Tetenlann lesen Gelber, CHPOA is the Catal Inet tne CF

a

Ihe Chis Medica Diseeter ef Communit

Conaesomty Hospice, Devenaiaet aes L, Ray,

oss:

caf Delian! Misty Sooke

sant Mee

1 sed Seaseus of Life

Medina suvines Delencant sacs Bure, MD is abo the Acsistear Mecieal Dusctoe of

Cemmurity Hoxpive (cole

A

dest GowhCor “Jeeh Sewer, i te gaueat compssy’ of SombCoxet

LLC ith: Adeniseative a 3: Sami Tories, Savane

Soha Heh hes $24 pivpsieeas an€ medio.’ profeestemlsi~ 8 Teas

Savenaah, Rishon] The. Poor, Runes, Bo

SonthCoest Boal eta corgaensusres “geceal services iacludiep, Faanily Medieape, new!

Modine Obsenice & Gynecelogy, Pesiatrig, Aleruy sou bits snags, Céadiokoay

Cate

Toayirg, laleetious iscaso, Nophzelegy Veuetuey, My!

es Thecapss Pediat. 2am

1p Medicine, Suipeny, (lineal Tal Researeh Studies, Lis

tie Sel? Managences Trairing
Srsfirns Tietetic Uauzgcng, Aigh Rish Tess! Cancer (lite, Labaysiory Services, Massage
Therap, Opvival Shop, Pharancy, acd Weekend Care, Defeucaut Sheedere Getfon, MD isthe

Hand cl SoutiUsest Medeor; Liecevéan Tharsis Moclaaty, MLL is second a9 charge =

SoathCuass Medical fcocetivesy relieve le eres: = "SawsuCoass Meée3!)
1 Prot heath, ne services eeammnusiies 1 Coose.e, Noch Save read

Florida, Deus Lselsh Seinah is oested at C2822 White Bort Rew. Savery Georgie

51419, These are IMG Meslisars Mead I

afc Dahinda Pratt Tealth Vespion

S

seamless cearee 219.00 White TlueT Road. suite 304, Savers Gena 21419, Defiant

Neth, te isthe ©

sefomed to bovein as "Pru 1B

‘rian we CEO Leallers vel

elerer oie Tob bepan weakag fer Betheny “9 Davercher 2014 as acrarketer

snd sas te. onsated Tals 20

Va Reluaw Mesbie Seley’ aegan omrkieg cov Tedany 1 Decersbee 2

“A depot anv was ee dnated Sue 2055,
Iv, SFATURS AND RAGHLATIONS

A. Medicare and Mecieuid Proweans

16, ‘Title XWILL of hs Seis” Security Act 42 ULS.C. $1395 e4 sero

Treat. eusmaee:

be Agee end Tieulled P.uguea, sopulstiy anesm asthe Metre:

Joe Seeretay ef the Vriwd States Deyciumen! of Keak and Mumer Series CLUS)

anmiinises he Mesicere Progra thictuh she Cavers for Medicare and Medica‘d Sev

CMS, eminent ef HRS.

V7, Phe Medicae progrsrs crrsiss.e1 several parts, Medicate Ps

2s proviees bes

‘nsuranoe tos

woof hosp alization and past-hogpitaliation sats, “2

(1982) Medivae Pact 3 ise fedesal’y subsidies, velantary incwiaces.peegrsin thes covers caren

nun-hospite medieal semdens ans groves ineche Ee weatie

TLS. § 12951, 12950), 15045) -Bwehunenre fe Medion claims is ads be

hs Uae

sutess:9 edmisasnss acd sey

Sates mug CMY, CIS, i. mn, centre's wile pene ina

Moalare Pat 8 caine fe ars Trost Yane, 22 S00 £ 2385ir; In thés eapacey
jets act on becalfol OMS, 22 CR $422.30 GM)
18, Tn arden sa yernive Medicare fads, orra'Tat suppliers. ineivelg 0
sether wih: the! suthorived syes employees, ocd eontruclons, ane regres at ©

svcvisnane ul Pe Sila See oy ci he aya ore

sate uncer she: € all applicable

plicies am oo issue hy she stes express’ y ste di, a provide must eof tat it 3 ae

cove pliange oi) aN Seder] and stale sas ies und regulasions fr onies ta rosva peypnent fom

Medicare a: tian Medicad, 42 CR. #435, el 24

18 Asuing the cules und reyulatione lcs entulled suppers inching afondsite

(11 bOL Mecieare for anty these cuvered versie: whic

ecies

2) net il Miccacave fox am’ scevicea or mo4.s vlc’ ete wi ger toersal ee die

‘viva all applcatle sells. cer subanl rte infor ation relting

revi castgor somos: Lj ngt sags in ey act ey ergs het oaastcnes oF 2828 in were

uilivatina of serie Aik Vices sd Tae apalieasle state ara feeval

Ios te prfenan Gye secvices provided ti recipients, (2) enarply wth state and 4 aces,

povicies xd segulscions aleable t Medwece, snd i cet ese irc Mga acy enatad

Ihe funistaag af sexsiecs te weupacts

“Je XIN af the Soma} Secon Ae, <2 WISI. € 1546, et ey. establishes

ly sass el great program for the Stvtes, Mc yestheS

Magical. levtn provide

specie] nosistarse ard celotoe sravicos a needy indivignels CMS adanistas Mlecnea'd on the

ach se acaades

Federal jewel, WEIhi~ proud feders s.09, he seapitve fie Radic

Ihe sersives exons, papmcent levels fer saviens ea€ edkmiciecative and «

tinal ps

Medicnid axhoriees grants “9 sites for mofies! essisteces w cluldeer ax Bind eed, and

dicahied inlividanle whose ines ard eserences ms “ot sutficent 49 a16es ae casts Ee nee sy
sydieal care, 42. U.S.C. § 1995. 42 CRA. $420, 2.996 § 2396

396. The Medicaid

Proghars i jntly Funded Ly the fecevel gevemnment ard pateijaring slats

2 avall tunes

jot to is Cevaplsinl, he Tniied Sues provised fonds ee
States Urnugh the Medicaid scogiem, welled providers nl medical services to Mesiosis

recipients are algibie feu popument for cow

cil weial versives cress provisions cf Tle NIX.

sslthe 1985 Aneaduiears co tas Kederal Social Securiy Act, By bees

rapa

cijating gcvider

eid, cwclh Jens agiee “9 abide hy Lae 1a es, regulations, atdices and procedures

goversing clemms os anya ard :0 keep end =Toveancess to secords and afoxniaton as equiced

by Meéisant 8 epeor 9 rece Wedicaid

emolieg svovnders. together with ectho=

agents, cinployers, and cerinacters, are reouieuil lo abide ay al. che provisions of tae Secial

ity Aot, she tezalations premulyates wae: the Ast, mx Lapaticable poneins nd svesna ces

noun ay he Stee

AU all ices ccoevait 20 chis Comp'ainl, Defenslerts mers participating, ar
Medivae:Medvcate peovcer

23 all cies cdsamt to lids Cerghkie, Mocaaciniedicad ctstituied axe

<coniinass 6 cons # revenne for Lefendsats

YA Delendenus submitted &. eared 16 be siominae fesse clams for aaymen

scare Mecca lor services ad Se

and Medea Toxpice Cuverass

siwss ace ¢ mosily Za profit he:

Fewaly

sh

rations. ar érapleyees “ae

ceipt of Mee eatiseil €or em hehe Tn

inst whis are s.ppused ts be sugilve ta asceive MeticrsniModiceé hospice benefits. Ose

ef the purses sre Meticace and Medico keopies reeuizar-ents Sst ensure thal tke Hv