False Claim Act Settlement with Visiting Physicians Association

Visiting Physicians Association will pay $9.5 million to settle for submitting false claims to Medicare, Medicaid and the military TRICARE medical program.  The doctors' group submitted false claims for unnecessary home visits, tests and procedures, as well as services that were never provided.   The claims were for people with Medicare, Medicaid and the military TRICARE insurance programs.   The settlement resolves four lawsuits filed by private plaintiffs under provisions of the False Claims Act, which permit private parties to file an action on the government’s behalf and share in any recovery. This settlement provides that the four whistle-blower plaintiffs will collectively receive a total of approximately $1.7 million.

Visiting Physicians Association, which has provided home health services in Michigan, Ohio, Georgia and Wisconsin, will make the payments to the U.S. government and the state of Michigan, to settle the allegations that it submitted claims for unnecessary home visits, unnecessary tests and procedures and other services it never provided.


 

False Claim Act

Regency Nursing and Rehabilitation Centers Inc. nursing home chain will pay the United States $4 million for submitting false claims to Medicare and the Texas Medicaid program, the Justice Department and the U.S. Attorney's Office for the Southern District of Texas announced today. The Victoria, Texas-based chain currently owns and operates 24 nursing home facilities located through the state.  The amount they stole it undetermined.  The charges included false hours and payment for services not rendered to residents.

The False Claims Act settlement resolves allegations that Regency submitted claims for reimbursement to Medicare and Medicaid for rehabilitation and skilled nursing services that were not reimbursable because the nursing home residents were not qualified for the services, the services were not medically necessary, or they were not supported by adequate documentation.

"Nursing home providers participating in Medicare should be on notice that taxpayers will not absorb the costs of improper or false billings submitted to the government and that the Department of Justice will take action against them for submitting such claims," said Tony West, Assistant Attorney General for the Department's Civil Division.



 

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