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DOJ Skilled Nursing Facility Settlement Involving Rehab – Highest Ever

Skilled Nursing Facility Single Highest False Claims Act Settlements to Date

Personal Care Agency Fraud2017 saw the largest recovery from a skilled nursing facility under the False Claim Act.  Life Care Centers of America Inc. and its owner agreed to pay $145 million to settle allegations that it caused skilled nursing facilities to submit false claims for rehabilitation therapy services that were not reasonable, necessary, or skilled.  The government’s case alleged that Life Care instituted corporate-wide policies and practices designed to place beneficiaries in the highest level of Medicare reimbursement.  High reimbursement categories were encouraged irrespective of the clinical needs of the patients.  The case alleged that this resulted unreasonable and unnecessary therapy to to be provided to many beneficiaries.

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Source: Health Law Blog

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John Fisher is a seasoned health care lawyer with more than 30 years of experience advising physicians and health care providers. His practice spans a wide range of issues, including physician investments in ambulatory surgery centers, concierge and cash-based medical practices, and health care fraud prevention. John is dedicated to helping his clients navigate complex legal challenges while protecting their interests and ensuring compliance in a rapidly evolving industry.
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