A settlement has been reached to resolve False Claims Act allegations against Signature HealthCARE LLC.
The allegations arose from a lawsuit that claimed Signature HealthCARE LLC (Signature) knowingly submitted false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary and skilled. In addition, allegedly, Signature submitted forged pre-admission certifications of patient need for skilled nursing to the state of Tennessee’s Medicaid program.
According to the government, allegedly, Signature engaged in various practices that resulted in the submission of claims for unreasonable, unnecessary, and unskilled services to Medicare patients, including: presumptively placing patients in the highest therapy reimbursement level, rather than relying on individualized evaluations to determine the level of care most suitable for each patient’s clinical needs; providing the minimum number of minutes required to bill at a given reimbursement level while discouraging the provision of additional therapy beyond that minimum threshold; and, pressuring therapists and patients to complete the planned minutes of therapy even when patients were sick or declined to participate in therapy.
“Health care providers who engage in deceptive practices place patients at unnecessary risk and contribute to the financial distress of our federal healthcare programs,” said U.S. Attorney Cochran for the Middle District of Tennessee. “Our dedicated teams of civil enforcement attorneys will work tirelessly with the relators who report fraud such as this and with our law enforcement partners who investigate healthcare fraud. When we determine that companies are cheating the taxpayers, we will hold them accountable as we have in this case.”
Under the settlement agreements, Signature has agreed to pay more than $30 million. As part of the resolution, the State of Tennessee will receive a portion of the overall settlement.
The whistleblower’s, former Signature therapy employees Kristi Emerson and LeeAnn Tuesca, will receive a portion of the recovered funds.
