United Energy Workers Healthcare: Unprovided Care, Inflated Hours, and Missing Licenses

In the United Energy Workers Healthcare fraud settlement, the company paid $9 million to resolve allegations of billing the Department of Labor for unprovided or medically unnecessary home health services. The government alleged that the company instructed caregivers to charge more time than they spent with patients, alongside claims for case management never performed, services outside program coverage and services supplied without required licenses.

The Justice Department’s February 7, 2023 announcement covered alleged conduct from January 2013 through March 2021. United Energy Workers Healthcare provided services in several states, including Ohio, to Department of Energy employees and contractors who were injured or became ill on the job. The claims at issue went to the Labor Department’s energy-worker compensation program.

The case puts the caregiver’s work beside the company’s request for payment. A nurse may know how long a visit lasted. A case manager may know whether the billed work happened. A billing employee may know who instructed staff to submit the larger claim.

What Are Some Examples of Home Health Care Fraud?

The United Energy Workers Healthcare allegations included billing for case management never performed, inflated caregiver time, uncovered services and services without required licenses. The settlement concerned claims submitted under the Department of Labor’s energy-worker program.

Case management never performed. The government alleged billing for case-management services that were not actually provided.

More time charged than spent. The government alleged that the company instructed caregivers to charge for more time than they actually spent with patients. That instruction connects the caregiver’s knowledge of the visit to a decision to claim additional time. In the government’s account, the caregiver stopped. The bill kept running.

Services outside program coverage. The announcement also alleged providing and billing for services to beneficiaries that the energy-worker program did not cover.

Services without required licensure. The government separately alleged providing services without possessing required licenses.

Home Care Under the Department of Labor’s Energy-Worker Program

The payer in this settlement was the Department of Labor, through the Energy Employees Occupational Illness Compensation Program Act. The provider served workers and contractors injured or made ill on the job, and the government’s allegations concerned healthcare claims submitted for beneficiaries of that program. The allegation puts taxpayers on the other side of the inflated bill, paying for care the company allegedly did not provide.

In a separate case involving the same Department of Labor energy-worker program, the complaint against Atlantic Home Health alleged billing for in-home nursing hours that patients did not receive. That case, like the United Energy Workers Healthcare allegations, concerned claims for care the beneficiaries did not receive.

Multiple Whistleblowers Brought Claims

Several whistleblowers brought qui tam claims under the False Claims Act, and the settlement resolved them. The Justice Department credited a coordinated effort by the U.S. Attorney’s Office for the Southern District of Ohio and the Department of Labor’s Office of Inspector General. The office’s civil team investigated the case.

Whether case management happened, how much time a caregiver spent and what staff were told to charge are all questions about the operation behind the claim. Someone who understands one of those decisions may be able to explain a discrepancy that the claim alone leaves hidden. A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

What Evidence Is Needed to Prove Fraud?

For a home health fraud case, the evidence has to connect what happened inside the business to the government’s bill. Our whistleblower experts work through that connection with you, including what the program covered and who directed the charge.

Your view may begin with one part of that chain: a visit, a case-management entry, a license issue or a billing instruction. You bring the knowledge of what happened inside the business; our work is to establish what it means for a whistleblower case.

You Know the Care Behind the Claim

If you saw energy-worker home care billed beyond the work performed, speak to our whistleblower experts about the care behind the claim. We build the case with you and bring in home health fraud whistleblower lawyers who understand claims to the Department of Labor. From the first conversation through the case, we stay on your side of the table.