The settlement resolves allegations that a nursing home company violated the False Claims Act by knowingly submitting false claims to Medicare for therapy services that were not reasonable, necessary, or skilled. The defendant allegedly submitted forged evaluations inflating patients’ needs for skilled nursing services and enacted other policies to designate as many nursing home residents in the highest level of Medicare reimbursement, regardless of their actual needs.
For their role in the investigation, the two Tennessee whistleblowers were awarded $1.4 million and $145,350 respectively.
The claims and settlement discussed above are allegations only. There has been no determination of liability.