SNF

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

June 9, 2020

Partner Jessica T. Moore was quoted in the Bloomberg Law article, Nursing Homes, States Vary in Meeting New Inspection Demands.  Click here to read the article.

April 14, 2020

A chain of nine skilled nursing facilities operating in seven states has agreed to pay $10 million to settle a whistleblower-brought suit alleging violations of the False Claims Act.  In the suit, former employees Hope Wright, Laura Webb, and Deborah Edmonds alleged that from 2013 to 2017, Saber Healthcare Group LLC improperly pressured therapists to provide Ultra High levels of rehabilitation therapy for all patients regardless of individual patient needs.  Ultra High levels of therapy involve a minimum of 720 minutes of therapy from two therapy disciplines, and are reimbursed at the highest rate possible by Medicare.  To enforce their illegal standard, Saber prevented therapists from providing lower levels of therapy, caused therapists to falsely report time, and pressured facility directors in daily or weekly calls.  As part of the settlement, Saber has agreed to a five year Corporate Integrity Agreement, and Wright, Webb, and Edmonds will receive $1.75 million of the settlement proceeds.  DOJ