October 15, 2018 - Posts

Nursing Homes Potentially Ripping off Medicare


Healthcare providers can rip off the federal government and its own workers in a multitude of ways. Bloomberg News “uncovered” another way this week through reporting that nursing homes are increasingly subjecting elderly residents to high levels of rehabilitation towards the end of their life. These high levels of rehabilitative care receive the biggest payouts from federal health insurance providers like Medicare. This is not news to us as our firm has been on the forefront of pursuing skilled therapy facilities for both defrauding Medicare and stealing wages from their therapists.


Research completed by the University of Rochester reveals that the proportion of nursing home residents who received the “ultrahigh” – more than 12 hours a week- rehabilitative therapy in the last 30 days of their life increased by 65% from October 2012 to April 2016. This research suggests that nursing homes may have financial incentives in pushing elderly patients into rehabilitative services. Additionally, the research discovered for-profit nursing homes were more than twice as likely to use the high level of classifications than nonprofit homes.


A $30 Million Settlement on Medicare Fraud:

This year we represented two whistleblowers in a $30 million settlement against Signature Healthcare. Signature Healthcare violated the False Claims Act by billing Medicare for unnecessary and unreasonable rehabilitative services so they could improperly increase Medicare reimbursements. Two occupational therapists reported the Medicare fraud and we filed their whistleblower lawsuit. To read about our case in the Tennessean click here.


Wage Violations in Skilled Therapy:

Skilled therapists can face wage violations in addition to seeing and reporting Medicare fraud. If a facility imposes impossible productivity requirements, skilled therapists may be forced to work off the clock to complete their work. This includes over-reporting meal breaks, clocking out early but continuing to finish work, and taking paperwork home to finish. These practices can violate the Fair Labors Standard Act. Click here to read our article on these violations.


If you are a therapist working off the clock due to impossible productivity requirements, or have witnessed unnecessary and fraudulent practices, send us a message or give us a call at (615) 244-2202.


While our office is located in Nashville, Tennessee, we handle cases all across the country. We represent healthcare workers in wage and overtime claims and whistleblower claims for fraudulently billing Medicare and Medicaid programs.

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