Wednesday, July 5, 2017
Submitting False Claims to Medicare for Providing Unnecessary Therapy to Nursing Home Residents
St. Louis, Missouri: The United States Attorney’s Office for the Eastern District of Missouri announced today that the United States, Reliant Care Group, Reliant Care Management Company, Reliant Care Rehabilitative Services, and a number of Reliant affiliated skilled nursing facilities (Reliant) reached a civil settlement that will resolve the United States’ claims against Reliant under the False Claims Act for knowingly submitting false claims to Medicare for providing unnecessary physical, speech, and occupational therapy to nursing home residents.
According to the United States’ allegations, from January of 2008 through April of 2014, Reliant provided unnecessary physical, speech and occupational therapy to nursing home residents who had a relatively high level of independence and who were residing in a skilled nursing facility primarily because of a psychiatric condition. The United States alleged that Reliant provided the unnecessary therapy and then sought the inflated reimbursement from Medicare influenced by its own financial considerations. The United States further alleged that some Reliant Care Rehabilitative Services management pressured therapists to provide therapy to residents even when the therapists believed that the therapy was not medically necessary.
As part of the settlement, Reliant will repay the United States $8,368,878.
Reliant has also entered into a five-year Corporate Integrity Agreement with the United States Department of Health and Human Services, Office of Inspector General (HHS-OIG). Pursuant to the terms of the Corporate Integrity Agreement, Reliant must comply with a number of reporting obligations to ensure that Reliant remains compliant with Federal health care program requirements.
Today’s settlement sends a message to those who seek to take advantage of the Medicare program. “Health care fraud is a major and increasingly serious problem that costs taxpayers millions in lost and wasted dollars while depriving vulnerable beneficiaries of the care and support they need,” said Special Agent in Charge Steven Hanson from HHS-OIG. “Every dollar that we save or recover allows us to better serve those who really need and deserve our help. We will continue to aggressively investigate these cases in an effort to eliminate the corruption in our health care system.”
This civil settlement is part of ongoing efforts by the Department of Justice and the United States Department of Health and Human Services to recover funds diverted from the Medicare Trust Account and is the result of the combined work of the U.S. Attorney’s Office for the Eastern District of Missouri, HHS-OIG, and the Federal Bureau of Investigation.