Rehab firm's overbilling will cost provider $1 million-plus

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LeadingAge President and CEO Larry Minnix
LeadingAge President and CEO Larry Minnix

The fallout from a recent spike in rehabilitation charges to government payers continued to make headlines in September. This time, a nursing home company was blamed for insufficient oversight of its contract therapy provider.

Episcopal Ministries to the Aging Inc. agreed to a $1.3 million settlement over charges that it did not prevent overbilling by RehabCare Group East Inc. at one of its facilities, William Hill Manor in Easton, MD. Earlier in the month, authorities announced a settlement for $3.8 million involving RehabCare and two other providers.

The Department of Justice charged in a False Claims Act lawsuit that RehabCare engaged in a variety of unscrupulous practices, including disregarding patients' clinical needs in order to place them in therapy categories that would reap improperly high Medicare reimbursements.

The settlement shows the government's commitment to “holding accountable all entities involved in billing for unnecessary services, including those that did not directly provide the unnecessary services,” stated Stuart F. Delery, assistant attorney general for the DOJ's Civil Division in announcing the deal Sept. 16.

RehabCare Group East, a Kindred Healthcare subsidiary, disputes the allegations. It is cooperating with DOJ investigators, according to a statement emailed to McKnight's.

RehabCare's “intense therapies” improve patient outcomes and reduce length of stay and hospitalizations, the statement read.

Some long-term care provider advocates have called for authorities to limit prosecution of such cases to just therapy providers, but not all agree.

 “I can't stress this point enough: the provider is ultimately accountable for the products and services that are delivered through contracts,” LeadingAge President and CEO Larry Minnix wrote in a blog post.