Medicare Fraud Settlement

Whistleblower Settlement

The IndyStar reported on a $5.5 million settlement over allegations of false claims and Medicare fraud.  American Senior Communities LLC (ASC) is a private company that operates dozens of nursing homes owned by Health & Hospital Corp. of Marion County.

The U.S. Attorney’s Office in the Southern District of Indiana announced the settlement.  ASC is the largest nursing home operator in Indiana. According to the U.S. attorney’s office, the estimated loss to the Medicare program totals more than $2.7 million.

Whistleblower Joseph Lingenfelter was an executive at a hospice care company that contracted with ASC. He proved that ASC charged Medicare for therapy services provided to hospice care patients even though ASC knew those services were covered by the patients’ Medicare hospice coverage.

Lingenfelter discovered other similar fraudulent activity. The fraud was widespread in the company. The whistleblower complaint is not the first allegation of fraud at ASC.

Fraudulent Shell Companies

In 2016, ASC CEO Jim Burkhart and four associates operated a $19 million fraud scheme involving shell companies, inflated invoices and kickbacks. All five pleaded guilty. The scheme resulted in overcharges onn everything from medical supplies to American flags. Prosecutors say the men used proceeds from the fraud to fund luxurious lifestyles that included vacation homes, private planes, golf junkets and Rolex watches.

ASC commissioned a report claiming 25 people participated in two dozen fraud schemes during Burkhart’s tenure amounting to $35 million.