Northern California Record

Saturday, February 29, 2020

Court dismisses suit over woman's allegations that Carelick Hospice Services committed Medicare fraud


By Charmaine Little | Nov 1, 2018

LOS ANGELES – A woman’s claims that a local hospice facility committed Medicare fraud fell short in the U.S. District Court for the Northern District of California, as her case was dismissed Oct. 1.

Yolanda Armstrong-Young sued her former employer, Carelink Hospice Services Inc., over allegations that it violated the False Claims Act (FCA) when it claimed reimbursements from Medicare patients whose hospice stays weren’t covered. The current complaint marked her third attempt, and the court determined she has yet to provide enough facts to prove fraud under Federal Rule of Civil Procedure 9(b). Because of this, District Judge William H. Orrick dismissed her claim.

The court pointed out that while Armstrong-Young accused Carelink of seeking reimbursement for patients who it allegedly was aware were not terminally ill, breaking Medicare Part A regulations, she didn’t specify any actual claims that committed the alleged fraud. It added that while she filed the lawsuit on behalf of the federal government, it has refused to intervene.

Regarding Armstrong-Young’s failure to allege fraud under the requirements of Federal Rule of Civil Procedure 9(b), the court agreed with Carelink that she fell short as she depended on general and broad accusations. The ruling states even though she provided a list of four patients who she said brought up concerns about their eligibility, she made it clear she only told a member of senior Carelink management about it.  

"This bare allegation does not describe the nature of Armstrong-Young’s concerns or her basis for believing that the four individuals in Exhibit D were not eligible for Medicare reimbursements for hospice care. She does not identify any reimbursements from Medicare made on behalf of the four individuals," the ruling states.

Armstrong-Young alleged Carelink retaliated against her because of her expressed concern about its alleged fraudulent activity. The court said her second amended complaint still doesn’t answer the basic questions of “who, what, when, where, and how” concerning the claim.

Because of Armstrong-Young’s failure to provide evidence or necessary details, her claim was dismissed without leave to amend.

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