Great Lakes Wire

United States Attorney Jerome F. Gorgon Jr. announced that M&Y Care, LLC has agreed to pay $334,807.20 to settle allegations of violating the False Claims Act. The company provides home health care services in Michigan and is based in West Bloomfield.

The settlement addresses claims that M&Y Care billed Medicare and Medicaid for services by unqualified staff from January 1, 2015, through December 31, 2023. It is alleged that the company used CPT code G0156 improperly for non-skilled care services, which should have been billed at a lower rate.

This civil settlement resolves claims under the qui tam provisions of the False Claims Act in the case United States and the State of Michigan ex rel. DeCarlo v. M&Y Care, LLC, et al., Case No. 19-11032 (E.D. Mich.). Under this act, private parties can file actions on behalf of the United States and receive part of any recovery.

The resolution was achieved through collaboration between the U.S. Attorney’s Office for the Eastern District of Michigan, U.S. Department of Health and Human Services - Office of Inspector General, and Michigan Attorney General’s Health Care Fraud Division. Assistant United States Attorney John Postulka managed the matter.

This case highlights government efforts to combat health care fraud using tools like the False Claims Act. Potential fraud can be reported to U.S. Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

It is important to note that these are allegations only; no liability has been determined.