Kindred Healthcare Inc. and its subsidiary RehabCare Group Inc. have agreed to pay $125 million to settle a whistleblower lawsuit on Medicare therapy claim overbilling. The settlement, announced by the U.S. Department of Justice, ended an investigation into claims brought against the companies by Janet Halpin and Shawn Fahey, former RehabCare therapists, in a 2011 lawsuit. The U.S. attorney’s office in Boston says RehabCare and four nursing facility operators submitted Medicare claims based on therapy services that were “unreasonable, unnecessary … or that never occurred.” The nursing home operators agreed to pay an additional $8 million. The company is now part of Louisville, Kentucky-based Kindred Healthcare. RehabCare has therapists in 46 states, including Florida, according to its website.
Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department made a statement regarding the settlement. “Medicare beneficiaries are entitled to receive care that is dictated by their clinical needs rather than the fiscal interests of healthcare providers. All providers, whether contractors or direct billers of taxpayer-funded federal healthcare programs, will be held accountable when their actions cause false claims for unnecessary services.”
The government’s complaint alleged that RehabCare’s policies and practices, including setting unrealistic financial goals and scheduling therapy to achieve the highest reimbursement level regardless of the clinical needs of its patients, resulted in Rehabcare providing unreasonable and unnecessary services to Medicare patients and led its SNF customers to submit artificially and improperly inflated bills to Medicare that included those services. Specifically, the government’s complaint alleged that RehabCare’s schemes included the following:
Call Edwards & Ragatz, P.A. if you or a loved one has been injured, neglected or abused in a nursing home — 1-800-366-1609 or email us at firstname.lastname@example.org for a free appointment to discuss your rights.