Oglethorpe Inc. (Oglethorpe), an operator of psychiatric hospitals headquartered in Tampa, Florida, along with its founder and principal owner, Robert Cohen, CEO John Picciano, and Chief Operating Office James O’Shea, have agreed to pay $32 million to resolve allegations that they violated the False Claims Act by knowingly failing to return overpayments received from the Medicare program for the admission of beneficiaries to three of Oglethorpe’s Ohio facilities.
The settlement resolves allegations that, from 2021 through the present, Oglethorpe and its executives knowingly failed to return to Medicare overpayments that Oglethorpe’s own consultants had identified. The overpayments related to beneficiaries who had been admitted to two hospitals (Ridgeview Behavioral Hospital and Georgetown Behavioral Hospital) and a substance abuse clinic (The Woods at Parkside), even though they did not qualify for inpatient psychiatric care.
“Healthcare fraud has negative impacts for taxpayers and patients alike,” said Assistant Attorney General Brett A. Shumate of the Justice Department’s Civil Division. “This settlement reflects the Department’s commitment to protecting taxpayer money and ensuring that Medicare payments are consistent with the coverage and payment rules for those services.”
“My office is determined to protect the public fisc and our fragile public health programs,” said U.S. Attorney Gregory W. Kehoe for the Middle District of Florida. “We will continue to pursue companies and individuals who defy Medicare’s regulations for personal gain.”
In 2021, Oglethorpe entered a Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General (HHS-OIG) following an earlier False Claims Act settlement with the Department of Justice. As a result of violating that Corporate Integrity Agreement, the defendants agreed to enter into a voluntary exclusion agreement with HHS-OIG under which they will be excluded from Medicare, Medicaid, and all federal health care programs for a period of 10 years beginning in July 2026.
“By enforcing the Corporate Integrity Agreement and securing a voluntary exclusion agreement the Department of Health and Human Services Office of Inspector General has demonstrated its unwavering commitment to protecting the integrity of federal health care programs,” said Chief Counsel Susan Edwards of HHS-OIG. “When entities fail to meet their obligations — especially after entering agreements designed to ensure compliance — we will take decisive action. This outcome underscores that accountability is essential to safeguarding both patients and taxpayer resources.”
The civil settlement concludes a lawsuit filed by four former Oglethorpe employees: Whitney Treloar, a registered nurse, Darren Caruso, former Chief Fiscal Officer, Jeanette Skinner, former Regional Director of Operations, and Joel Snook, the former Director of Financial Operations. The suit was filed under the whistleblower provisions of the False Claims Act, which permit private parties to sue on behalf of the government when they believe that a defendant has submitted false claims for government funds and to receive a share of the recovery. The relators’ share of this resolution has not yet been determined. The qui tam case is captioned United States ex rel. Whitney Treloar, et al. v. Oglethorpe, Inc., et. al., No. 22-cv-00238 (M.D. Fla.).
This year the Administration launched the Task Force to Eliminate Fraud and the National Fraud Enforcement Division to enhance the administration’s war on fraud, waste, and abuse in federal programs. When unscrupulous actors exploit these programs for their own financial gain, they defraud the government, harm the people these programs are designed to aid and protect, and undermine American businesses that play by the rules. The Civil Division’s FCA enforcement plays a critical role in combatting such fraudulent schemes, recovering billions of dollars for the American taxpayers, and holding wrongdoers accountable. FCA matters will continue to be on the forefront of the battle against fraud, and the Civil Division’s FCA work will support and advance the mission of the Task Force to Eliminate Fraud and the National Fraud Enforcement Division.
The resolution obtained in this matter was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section, and the U.S. Attorney’s Office for the Middle District of Florida.
Senior Trial Counsel Justin Draycott of the Justice Department’s Civil Fraud Section and Assistant U.S. Attorney Sean Keefe for the Middle District of Florida handled the matter.
The claims resolved by the settlement are allegations only and there has been no determination of liability.
