Modivcare Solutions LLC f/k/a LogistiCare Solutions LLC (“Modivcare”), the nation’s largest broker of non-emergency medical transportation (“NEMT”) services, has agreed to pay $3,750,000.00 to the federal government and state of Ohio to settle a qui tam lawsuit filed by three whistleblowers represented by Helmer Martins Tate & Garrett Co., LPA. The settlement resolves allegations that Modivcare submitted false claims for payment to Medicare and Medicaid by failing to ensure that the NEMT services it arranged in Ohio from December 2, 2009 to March 10, 2023 were medically necessary and eligible for payment.
These allegations were brought to the attention of the U.S. Department of Justice by three former employees of Mobile Care EMS & Transport, LLC (“Mobile Care”), an Ohio-based NEMT provider that did business with Modivcare. Relators’ lawsuit included separate qui tam claims against Mobile Care. The government intervened in the claims against Mobile Care but opted for the relators and their counsel to pursue the claims against Modivcare on behalf of the United States.
In the end, the law firm of Helmer Martins Tate & Garrett Co., LPA and the U.S. Attorney’s Office for the Southern District of Ohio worked together to resolve the claims against Modivcare. Separately, Mobile Care agreed to a settlement with the United States for the qui tam claims against it.
Under the False Claims Act, those with knowledge of fraud being committed against the government can be entitled to a portion of the recovery for reporting fraud. For the Modivcare claims, the government awarded the whistleblowers 28.5% of the federal portion of the settlement.
HMTG attorneys James A. Tate, B. Nathaniel Garrett, and Julie W. Popham represented the whistleblowers.
“The settlement of the non-intervened qui tam claims against Modivcare demonstrates how important whistleblowers are to detecting and stopping healthcare fraud,” said B. Nathaniel Garrett. “The U.S. Department of Health and Human Services Office of Inspector General has consistently identified that non-emergency medical transportation services are particularly vulnerable to fraud, waste, and abuse. Our clients had evidence that the largest broker of such services in the country was not ensuring that the medical transportation it was brokering was medically necessary as required for Medicare and Medicaid reimbursement. Our clients stepped forward to stop this behavior, and they became entitled to a significant portion of the recovery for doing so. I commend our clients for pursuing this matter and for their patience over the duration of this 8-year case.”
“I echo my colleague’s praise for our clients, who were concerned about fraud, waste, and abuse in critical government programs and stood up to do something about it. Litigating declined False Claims Act cases against the most sophisticated, well-funded defense counsel in the country is hard, risky, and often arduous. The outcome in this case shows that our clients don’t run from a fight, and their counsel at Helmer, Martins, Tate & Garrett won’t either.” said James A. Tate.
Although the qui tam claims against Modivcare and Mobile Care have been resolved, HMTG is continuing to pursue a retaliation claim on behalf of one of the whistleblowers against Mobile Care. Trial on the retaliation claim is scheduled for December 2023.
The whistleblowers and their counsel wish to extend a special thanks to Assistant United States Attorneys Andrew Malek and Linda Mindrutiu from the Southern District of Ohio for their collaboration and assistance in resolving this matter. Even though the claims against Modivcare were non-intervened, the government actively monitored HMTG’s prosecution of this matter and AUSAs Malek and Mindrutiu were instrumental in helping reach a great resolution of this case for the United States and the State of Ohio.
About Helmer Martins Tate & Garrett Co., LPA
Helmer Martins Tate & Garrett Co., LPA has prosecuted False Claims Act cases on behalf of whistleblowers longer than any law firm in America. Since 1984, we have lectured, authored treatises, written articles, litigated, and lobbied for the rights of whistleblowers who come forward to protect the public treasury. Our cases have been featured in the Wall Street Journal, the New York Times, and on the television show, 60 Minutes. Our lawyers are repeatedly recognized by organizations such as Best Lawyers in America, the National Law Journal, Super Lawyers, US News and World Report, and Taxpayers Against Fraud. HMTG’s lawyers have represented clients in three False Claims Act cases in front of the United States Supreme Court over the last 15 years. Collectively, our False Claims Act cases have recovered more than $1 billion.
We pride ourselves on litigating some of the toughest and most complex cases in the country—especially those under the Federal False Claims Act. Under the False Claims Act, those with knowledge of fraud being committed against the government can be entitled a financial reward of between 25% to 30% of any recovery when the government declines to join the case.
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