The government alleged Foothill Ranch, Calif.-based Skilled Healthcare Group and its subsidiaries violated the False Claims Act by billing Medicare for hospice services provided to patients who were not eligible for those services and improperly billing for certain physician evaluation management services from April 1, 2010, through March 31, 2013. Genesis acquired Skilled Healthcare Group after the alleged improper billing occurred, according to the DOJ.
The government further alleged that from Jan. 1, 2005, through Dec. 31, 2013, Skilled Healthcare Group and its subsidiaries billed government payers for more therapy minutes than certain patients received.
The settlement also resolves allegations that from Jan. 1, 2008, through Sept. 27, 2013, Sun Healthcare submitted false claims to Medicare for medically unnecessary outpatient therapy services provided to patients in Georgia. Genesis acquired Sun Healthcare in December 2012.
“It’s disturbing when healthcare companies bill Medicare and Medicaid to care for vulnerable patients, but provide grossly substandard care and medically unnecessary services just to boost company profits,” said Special Agent in Charge Steven J. Ryan of HHS’ Office of Inspector General. “We will continue to crack down on medical providers who betray the public’s trust and the needs of vulnerable patients through fraudulent billing and irresponsible practices.”
The allegations against Genesis were originally brought under the qui tam, or whistle-blower, provision of the False Claims Act.
More articles on legal and regulatory issues:
Patient takes state trooper’s gun, shoots nurse at Florida hospital
7 latest healthcare industry lawsuits, settlements
Georgia pharmacy, pharmacist to pay $2.2M to settle false billing case
Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit
