Skilled nursing facilities are facing more scrutiny from the federal government and are the target of several healthcare fraud enforcement actions, according to Bloomberg BNA.
Joseph E.B. "Jeb" White, a whistle-blower attorney with Nolan Auerbach & White, told Bloomberg the DOJ is increasingly investigating SNFs for medically unnecessary therapies, which has spurred whistle-blower cases targeting SNFs.
Here are three things to know about three recent fraud cases involving SNFs, according to Bloomberg.
1. In a pending lawsuit against SavaSeniorCare in Atlanta, the government claims SSC officials violated the False Claims Act by pushing unnecessary intensive physical therapy on Sava patients to increase Medicare payments. The scheme reportedly took place from 2008 through 2012.
2. In September, Dana Point, Calif.-based North American Health Care, which operates 35 skilled nursing facilities, and two of its executives agreed to pay nearly $30 million to resolve allegations they violated the False Claims Act. The government claimed NAHC violated the False Claims Act by submitting claims to Medicare and Tricare for medically unnecessary rehabilitation services.
3. In July, three owners and operators of SNFs in Miami were charged criminally in connection with a $1 billion fraud scheme. The government claims the co-conspirators billed government payers for medically unnecessary services.
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