A settlement has been reached to resolve False Claims Act allegations against nine skilled nursing facilities and a pair of consulting firms.
The allegations arose from a lawsuit that claimed Southern SNF Management Inc, Rehab Services in Motion dba Dynamic Rehab and nine affiliated skilled nursing facilities in Florida and Alabama submitted or caused the submission of false claims to Medicare for medically unnecessary rehabilitation therapy services.
According to the government, allegedly, between October 2009 and December 2013, Southern SNF, Dynamic Rehab and the nine skilled nursing facilities’ corporate policies and practices encouraged the provision of medically unreasonable and unnecessary therapy without regard for patient’s individual clinical needs. The companies’ actions resulted in the submission of false claims based on inflated Resource Utilization Group levels. Medicare reimburses skilled nursing facilities based on a patient’s Resource Utilization Group level, which is supposed to be determined by the amount of skilled rehabilitation therapy required by the patient.
“Today’s settlement demonstrates our continuing commitment to ensure that Medicare providers do not place their own financial gain over patients’ clinical needs,” said Acting Assistant Attorney General Chad A. Readler of the Justice Department’s Civil Division. “Such conduct is especially unacceptable when it seeks to take advantage of older Americans, who are some of the most vulnerable members of our community.”
Three whistleblowers, former SNF Management employees La-Wanda Davis, Tramecier Donald, and Megan Dinkins, will receive $2 million as part of the settlement.
