Tuesday, November 21, 2017

Updates on Three Cases Against Nursing Centers

The Department of Justice (DOJ) has filed a motion to drop a False Claims Act lawsuit it had joined against HCR ManorCare in 2015. The whistleblower lawsuit had asserted that the provider submitted false claims for levels of rehabilitation services that weren't medically necessary in order to boost its reimbursements. Last month the judge struck an expert witness’ testimony and ordered DOJ to pay HCR ManorCare’s legal fees.

Four San Diego-area nursing centers owned by Brius Management Co. have agreed to pay up to $6.9 million to resolve civil allegations that their employees paid kickbacks to hospital discharge planners for patient referrals and submitted fraudulent bills to the government. In the Deferred Prosecution Agreements, the four nursing centers admitted that their employees conspired to pay kickbacks without the knowledge of the management company. 

The nursing centers have entered into a Corporate Integrity Agreement with the Office of Inspector General (OIG) as part of the settlement to resolve the whistleblower case. The hospitals also agreed to pay up to $4.9 million if certain operational contingencies are met.

The DOJ has announced that Hyperion Foundation and its former President, AltaCare Corporation and its Chief Executive Officer, Long Term Care Services Inc., and Sentry Healthcare Acquirors Inc. have agreed to pay $1.25 million to resolve allegations brought by a whistleblower. The government alleged that from October 2005 to May 2012, Hyperion made claims to Medicare and Medicaid for providing effectively worthless services to residents at the Oxford Health and Rehabilitation nursing center, which was managed by AltaCare.

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