Amedisys, Inc.
AMED, one of America's leading home health and hospice care
companies, announced today that the company has finalized its previously
announced settlement to bring to an end the civil investigation brought by the
U.S. Department of Justice ("DOJ").
Amedisys has fully cooperated with the DOJ civil investigation, which involved
Medicare reimbursement for home health services provided by certain Amedisys
care centers from January 1, 2008 through December 31, 2010. The settlement
also resolves a previously disclosed Stark Law issue regarding care
coordination services provided to a physician practice group in exchange for
compensation that was not consistent with fair market value during the period
April 1, 2008 through April 30, 2012, which the company voluntarily
self-disclosed to the Centers for Medicare and Medicaid Services.
As previously announced, although Amedisys disputed the DOJ's allegations of
misconduct, it decided to settle to avoid the cost and uncertainty inherent in
protracted litigation. The DOJ investigation primarily centered on
determinations made by Amedisys clinicians and independent physicians that
patients were homebound and needed skilled nursing or therapy services, and
that the services provided were medically necessary. Each year, Amedisys'
dedicated clinicians provide care to more than 360,000 patients, many of whom
suffer from more than one chronic and debilitating disease.
Amedisys maintains that it operated according to stringent policies requiring
that home health nursing and therapy services be delivered to qualifying
patients having a medical need for such care, and only upon the direction of
their physicians. Amedisys provides extensive training to its clinicians
concerning these requirements and has made significant investments in its
compliance program, which has been designed to comport with guidelines
established by the Office of Inspector General, United States Department of
Health and Human Services. The final Settlement Agreement reflects Amedisys'
disagreement with the DOJ's claims and includes no admission or determination
of wrongdoing.
"We are pleased to put this matter behind us," stated Ronald A. LaBorde,
President and Interim Chief Executive Officer. "We are intensely focused on
achieving the best possible outcomes for our patients by providing the care
they need, when they need it, in the comfort of their own homes. We strive
diligently to ensure that our operations are fully compliant with Medicare
program requirements."
Under the terms of the civil settlement, and as disclosed previously, Amedisys
will pay a total of $150 million plus interest in two installments. The first
installment of $115 million plus interest must be paid by May 2, 2014, and the
remaining $35 million plus interest must be paid by October 23, 2014. The
company will fund the settlement through cash on hand and draws upon its
existing credit facility.
Amedisys took the charge associated with the settlement in the third quarter
of 2013. In addition to the amount to be paid to the United States, the
company will be responsible for payment of attorneys' fees and expenses of
various qui tam relators in the amount of approximately $3.9 million, which
will be recorded in the first quarter of 2014.
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