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