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This archive displays posts tagged as relevant to fraud involving skilled nursing facilities. You may also be interested in our pages:

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May 10, 2021

Iowa skilled nursing facility Dubuque Specialty Care, owned by Care Initiatives, will pay $214,200 to resolve claims that they received federal Medicaid funds during a COVID-19 outbreak at the facility while failing to adhere to requirements for infection control, including procedures for screening symptomatic employees for COVID-19.  USAO ND Iowa

Disturbing New Evidence Suggests Fraud Underlies Five-Star Ratings for Some Nursing Homes

Posted  03/19/21
By Jessica T. Moore
Nurse helping elder man walking in rehab facility
Twelve years after the implementation of the nursing-home star-ratings system, a disturbing New York Times exposé and a lawsuit by California against Brookdale Senior Living reveals how the ratings are manipulated to the detriment of families in their time of crisis.  The NYT’s investigation and California’s allegations in combination paint the troubling picture of profits tied to higher star ratings, and...

DOJ Previews False Claims Act Enforcement Priorities for 2021

Posted  03/5/21
Department of Justice Seal on the United States Flag
The False Claims Act is the federal government's primary enforcement tool to combat fraud against the public.  Every year the government recovers billions of dollars under the statute, primarily with the help of whistleblowers.  Under the so-called qui tam provisions of the act, whistleblowers are authorized to act as private attorneys general and bring lawsuits on behalf of the government and recover a portion of...

Constantine Cannon and AARP Foundation Represent Advocacy Groups on behalf of Nursing-Home Patients to Ensure Facility Accountability

Posted  01/22/21
nurse checking elderly woman
Constantine Cannon LLP proudly joins the AARP Foundation in representing the National Consumer Voice for Quality Long-Term Care and California Advocates for Nursing Home Reform in a lawsuit seeking to roll back a directive undercutting accountability for nursing homes that violate federal standards.  The federal Nursing Home Reform Act of 1987 allows states to recommend to CMS that a non-compliant facility pay civil...

January 11, 2021

California-based AutoGenomics, Inc. has agreed to pay over $2.5 million to settle allegations of submitting kickback-tainted claims to Medicare.  Between 2013 and 2015, AutoGenomics allegedly paid kickbacks to a healthcare marketing company for each genetic test performed by AutoGenomics’ former laboratory, PersonalizeDxLabs.  The kickbacks were only paid if the claims were reimbursed by Medicare.  Pursuant to the agreement, the company linked up with Prestige Administrative Services, LLC, which owns and operates residential nursing homes in multiple states, to identify and obtain samples from Prestige’s Medicare patients to send to PersonalizeDxLabs, in violation of the Anti-Kickback Statute and the False Claims Act.  USAO WDWI

Watch: Jessica Moore Discusses Assisted Living Facility Safety on Tampa’s ABC Action News

Posted  09/4/20
wheelchair in the hospital lobby
Constantine Cannon has been following the impact of COVID-19 on nursing homes and assisted living facilities.  Residents and workers at nursing homes make up a disproportionate share of U.S. coronavirus deaths, and the pandemic has imposed unique burdens on the industry. Florida recently implemented standards that will allow visitors in to long-term care facilities, if those facilities meet specific criteria. ...

Whistleblowers Are Critical to Exposing Fraud in the Murky World of For-Profit and Private-Equity Nursing Home Operations

Posted  07/17/20
By Jessica T. Moore
person following a trail of money
The settlement of a fraud case against 27 skilled nursing facilities controlled by private owners demonstrates “the power of whistleblowers to shine a light on improper business practices and obtain significant recoveries on behalf of United States taxpayers.”  (U.S. Attorney Nick Hanna, C.D. California.)  The government’s recognition of the contributions of whistleblowers in the False Claims Act case against...

July 13, 2020

The owner and operator of a skilled nursing facility has agreed to pay $1 million to settle allegations of submitting false claims to Medi-Cal in violation of the California False Claims Act.  According to the Attorney General, Legacy Post-Acute Rehabilitation Center (Legacy) failed to provide the minimum number of nursing hours required for the level of care that it billed for.  AG CA

July 13, 2020

Longwood Management Company and 27 affiliated skilled nursing facilities have agreed to pay $16.7 million to resolve allegations raised by whistleblowers Judy Boyce, Benjamin Monsod, and Keith Pennetti in two separate qui tam filings, that six Longwood facilities knowingly submitted false claims to Medicare.  Between 2018 to 2012, Longwood allegedly pressured its rehabilitation therapists to increase the amount of therapy provided to Medicare Part A patients, regardless of medical necessity, so it could claim Ultra High levels of service, which are reimbursed at the highest rate.  As part of the settlement, Longwood will enter into a five-year Corporate Integrity Agreement, and Boyce, Monsod, and Pennetti will share a $3 million award.  DOJ; USDC CDCA

July 8, 2020

A Florida-based nonprofit that provides hospice care, palliative care, and other services to the elderly, has agreed to pay $3.2 million to resolve its liability under the False Claims Act.  According to former Director of Hospice Care, Margaret Peters, Hope Hospice knowingly submitted false claims to Medicare, Medicaid, and TRICARE for medically unnecessary but highly reimbursed general inpatient (GIP) hospice services over a five year period.  For blowing the whistle on the alleged fraud, Peters will receive a 19% share of the settlement.  USAO MDFL
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