July 29, 2022

Old Man’s Home of Philadelphia d/b/a Saunders House, a skilled nursing facility, will pay $819,640 for its violations of the False Claims Act. A whistleblower filed suit under the qui tam provisions of the FCA, alleging Saunders House overbilled federal healthcare programs for therapy services provided; billed for therapy services not provided; billed for unreasonable, unnecessary, and sometimes harmful therapy; and manipulated clinical services to maximize billing. Medicare Part A paid Saunders House based on beneficiaries’ assigned Resource Utilization Group, and Saunders billed at the highest RUG level—Ultra High or RU—despite the lack of reasonableness or necessity for the patients. USAO EDPA

Tagged in: FCA Federal, Healthcare Fraud, Medical Billing Fraud, Medicare, Provider Fraud, SNF, Upcoding, Whistleblower Case,