SNF
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June 16, 2017
Pennsylvania-based skilled nursing facility operator Genesis Healthcare Inc. agreed to pay roughly $53.6 million to settle charges that companies and facilities acquired by Genesis violated the False Claims Act by causing the submission of false claims to government health care programs for medically unnecessary therapy and hospice services, and grossly substandard nursing care. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Joanne Cretney-Tsosie, Jennifer Deaton, Kimberley Green, Camaren Hampton, Teresa McAree, Terri West, and Brian Wilson, former employees of companies acquired by Genesis. They collectively will receive a whistleblower award of $9.67 million from the proceeds of the government's recovery. DOJMay 31, 2017
New Jersey-based skilled nursing facility Andover Subacute and Rehab Center Services Two Inc. agreed to pay $888,000 to resolve charges it violated the False Claims Act by providing materially substandard or worthless nursing services to patients. DOJ (DNJ)May 16, 2017
Omnicare Inc. agreed to pay $8 million to settle charges it violated the False Claims Act by submitting claims for generic drugs different from those actually dispensed to Medicare and Medicaid beneficiaries. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Elizabeth Corsi and Christopher Ezzie. They will receive a whistleblower award of more than $2 million from the proceeds of the government's recovery. DOJ (DNJ)April 10, 2017
Kentucky based nursing home operator Prestige Healthcare agreed to pay $995,500 to resolve allegations it violated the False Claims Act with regard to its role in an alleged scheme to falsely bill Medicare for unnecessary genetic testing. According to the government, Prestige provided genetic testing company Genomix LLC with information on and access to Prestige nursing home patients without ensuring physician orders were obtained for the testing and where Prestige physicians were not aware of and did not agree with the medical necessity of the testing. DOJ (WDWI)Nursing Home Operators Face Over $115M for Medicare Fraud
Posted 02/20/17
By the C|C Whistleblower Lawyer Team
On February 15, a jury in the United States District Court for the Middle District of Florida found the operators of 53 skilled nursing facilities liable for over $115 million from false claims submitted to Medicare and Medicaid. The fraudulent claims involved a scheme where nursing facilities pretended patients needed and in turn received more care than they actually needed....
September 19, 2016
North American Health Care Inc., a California-based operator of dozens of skilled nursing facilities (along with its Chairman John Sorenson and Senior Vice President of Reimbursement Analysis Margaret Gelvezon) agreed to pay $30 million to resolve charges they violated the False Claims Act by billing for medically unnecessary rehabilitation therapy services. Whistleblower InsiderDOJ Catch Of The Week -- North American Health Care
Posted 09/23/16
By the C|C Whistleblower Lawyer Team
This week's Department of Justice "Catch of the Week" goes to North American Health Care Inc. On Monday, the California-based operator of dozens of skilled nursing facilities -- along with its Chairman John Sorenson and Senior Vice President of Reimbursement Analysis Margaret Gelvezon -- agreed to pay $30 million to resolve charges they violated the False Claims Act by billing...
Trend Alert: Nursing Homes Profit at the Expense of Vulnerable Patients
Posted 09/22/16
By Max Voldman
Monday’s announcement of the DOJ’s $28.5 million settlement with North American Health Care (“North American”) is the latest in a disturbing trend of healthcare companies profiting off of medically unnecessary services provided (and sometimes not even provided) to America’s seniors. North American, a chain of 35 nursing homes in California, allegedly billed thousands of procedures to...