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A Louisville, Kentucky-based nursing home facility will pay more than $30 million to resolve False Claims Act charges over its Medicare billing practices, says the U.S. Justice Department.
The president of Signature HealthCARE L.L.C. said in a statement the settlement permits the firm to move forward.
The Justice Department said in its statement Friday that Signature agreed to resolve allegations it violated the FCA by knowingly submitting claims to Medicare for rehabilitation services that were “not reasonable, necessary and skilled.”
It said the settlement also resolves allegations that Signature submitted forged preadmission certifications of patient need for skilled nursing to Tennessee’s Medicaid program. As part of the resolution, Tennessee will receive a portion of the overall settlement, the Justice Department said in its statement.
The Justice Department charged Signature had presumptively placed patients in the highest therapy reimbursement level rather than relying on individualized evaluations, provided the minimum number of minutes required to bill at a given reimbursement level, and pressured therapists and patients to complete the planned minutes of therapy even when patients were sick or declined to participate in therapy.
“Today’s settlement demonstrates our continuing efforts to protect patients and taxpayer by ensuring that the care provided to beneficiaries of government-funded health care programs is dictated by clinical needs, not a provider’s fiscal interests,” Acting Assistant Attorney General Chad A. Readler for the Justice Department’s Civil Division said in a statement.
“Nursing home facilities provide important services to our elderly, and those facilities must uphold the trust placed in them by billing the government only for reasonable and necessary services.”
Signature president and CEO Joe Steier said in a statement, “This settlement allows us to move forward in serving our residents and families with quality health care and a commitment to compassion.
“We worked with the government over the past year to get us here. Resident care remains our first priority, and therapy services are and remain an important part of that care. We are more focused than ever on our mission to serve each resident and family with excellence, and will continue to work hard each and every day to deliver great outcomes for our residents.”
A law firm analysis said earlier this year that the Trump Administration is aggressively pursuing False Claims Act cases and is expected to continue to do so.
Axis Capital Holdings Ltd. on Friday said Axis Healthcare has entered the nursing home professional liability market by bringing on underwriters Dave Stoner and Jason Correll.