Skilled nursing providers, billing consultants pay $6M to resolve whistleblower allegations

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Four SNFs have resolved federal fraud allegations
Four SNFs have resolved federal fraud allegations

Four skilled nursing facilities and two financial consultants they used to bill for therapy services agreed last week to a $6 million settlement to resolve fraud allegations.

The U.S. Attorney's Office in Baltimore announced the resolution Thursday, noting the allegations were connected to billing for both Medicare and Tricare beneficiaries. The accusations stem from whistleblower allegations and were brought under the False Claims Act.

The government accused the four SNFs and the two consulting companies of systematic false reporting of the number of minutes skilled therapy was delivered and said that they mischaracterized the necessity of therapy in some cases. By increasing minutes in many instances over a four-year period, the company was able to bill at higher reimbursement rates, according to a press release.

Caring Heart Rehabilitation and Nursing Center in Philadelphia agreed to pay the United States nearly $1.3 million; Gowanda Nursing Home in Buffalo agreed to pay $811,153; Ocean Promenade Nursing Center in Rockaway Park, NY, agreed to pay $608,365; and Riverview Rehabilitation and Health Center in Essex, MD, agreed to pay $1.2 million. In addition, Global Healthcare Services Group, LLC, agreed to pay $190,000 and GHC Clinical Consultants agreed to pay $1.8 million. Both consultants are based in New Jersey, the U.S. Attorney's Office said.