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Nursing Home Operators Face Over $115M for Medicare Fraud

Posted  February 20, 2017

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. The allegations were brought to light by Angela Ruckh, a former nurse at two of the facilities. The defendants were CMC II, LLC, Salus Rehabilitation LLC, 207 Marshall Drive Operations LLC and 803 Oak Street Operations LLC.

The false claims for unnecessary care coupled with fraudulent records were sufficient for the jury to come to the conclusion that a major fraud against the government had occurred. The reality of the False Claims Act’s trebling provisions along with a penalty of between $10,000 and $22,000 per claim could lead to a true payment of over $345 million according to Constantine Cannon attorneys Mary Inman and Poppy Alexander.

CMC II faced the biggest liability at more than $109.8 million in damages for 123 false Medicare claims. Oak Street is liable for $3.3 million in damages, and Marshall Drive is liable for $2 million in damages. This case demonstrates a rarer example of a False Claims Act case going the distance to trial and the risk that defendants face in being found liable at trial and facing treble damages. This case also targets artificial increases of resources by nursing facilities, an area of interest to the United States Department of Health and Human Services’ Office of Inspector General according to Inman.

Tagged in: FCA Federal, Healthcare Fraud, Medicare, SNF,