Bon Secours Health Systems Inc. asked a New York federal judge to dismiss a health insurance fraud lawsuit brought against the company by two whistleblowers, saying that the plaintiffs’ False Claims Act allegations are “woefully deficient” because they failed to state a specific claim in their complaint.

A whistleblowers lawsuit, also known as a qui tam lawsuit, is a type of complaint filed under the False Claims Act against a company that has allegedly defrauded the United States government.

The company has requested that U.S. District Judge Richard M. Berman allow a pretrial conference before they filed their motion to dismiss the whistleblower suit, which alleges Bon Secours charged both Medicare and Medicaid for expensive and allegedly unnecessary treatments.

The complaint goes on to accuse the healthcare provider of altering patient records to make these individuals eligible for long-term home health care services provided by Bon Secours.

Bon Secours Health Insurance Fraud Lawsuit

According to the Whistleblower lawsuit, Bon Secours was able to go on with this health insurance fraud by promoting a “a culture of noncompliance” within its workforce, encouraging employees to break state and federal laws in order to make patients appear eligible for long-term home health care programs.

The allegations in this health care fraud lawsuit by plaintiffs Jo Ann D. and Melissa O. is based on other allegations brought against Bon Secours in the 2010 healthcare insurance fraud lawsuit known as Raffington v. Bon Secours Health System Inc., et al. According to the plaintiff company, the new whistleblower lawsuit against Bon Secours is blocked because of the FCA’s “first-to-file” rule.

Bon Secours goes on to argue that Jo Ann and Melissa failed to allege a specific incident involving false claims and furthermore failed to detail how the submitted Bon Secours claims were false.

The former Bon Secours employees who filed this whistle blower lawsuit claim that the health insurance provider committed various violations, including treating patients the company was allegedly not licensed to treat.

Additionally, the plaintiffs allege Bon Secours knowingly and willingly altered patient records’ scores, which are used to determine eligibility for long-term home health care services under both Medicare and Medicaid health insurance plans.

Finally, the plaintiffs accuse Bon Secours of offering and administering certain types of physical therapy to patients that didn’t need the service or took on patients that the health insurance provider was not equipped to care for.

The Bon Secours Whistleblower Lawsuit is United States of America et al. v. Bon Secours New York Health System Inc. et al., Case No. 1:13-cv-08792, in the U.S. District Court for the Southern District of New York.