The Department of Justice (DoJ) has announced the recovery of $4.03 million to settle whistleblower claims that a contract rehabilitation provider submitted false claims to Medicare. This settlement resolves three independent whistleblower claims brought under the False Claims Act (FCA). The whistleblowers allege that the rehab therapy provider at three skilled nursing facilities improperly billed Medicare in multiple ways, including billing for unskilled or medically unnecessary services, as well as improperly billing for group therapy as individual therapy.
This new settlement reiterates the DoJ’s continued emphasis on FCA enforcement in elder care.
The FCA allows whistleblowers who uncover fraud against the government to file lawsuits on behalf of the government and share in any recovery. The Act also provides whistleblowers with important protections against retaliation.
The settlement discussed above is based on allegations only. There has been no determination of guilt or liability.