Dana Point, Calif.-based North American Health Care and two of its executives will pay a total of $30 million to resolve allegations they violated the False Claims Act, according to the Department of Justice.
The government claims NAHC, which operates 35 skilled nursing facilities, violated the False Claims Act by submitting claims to Medicare and Tricare for medically unnecessary rehabilitation therapy services, according to the DOJ.
Margaret Gelvezon, NAHC senior vice president of reimbursement analysis, created the improper billing scheme and John Sorenson, chairman of the board, reinforced the scheme, according to the government.
Under the settlement, NAHC will pay $28.5 million, Mr. Sorenson will pay $1 million and Ms. Gelvezon will pay $500,000. NAHC will also enter into a five-year corporate integrity agreement with HHS' Office of Inspector General.
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