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Wednesday, June 30, 2010

Department of Justice

United States Attorney James R. Dedrick Eastern District of Tennessee


SETTLEMENT REACHED WITH BENCHMARK PHYSICAL THERAPY

CHATTANOOGA, Tenn–Benchmark Rehabilitation Partners, LLC, doing business as Benchmark Physical Therapy, has entered into a settlement with the United States and the State of Tennessee to pay over $1.8 million resolving allegations that it improperly billed the Medicare and TennCare/Medicaid programs for physical therapy services in violation of federal and state laws and regulations, U.S. Attorney Russ Dedrick announced today.

Benchmark provides physical therapy services to Medicare and TennCare/Medicaid patients in East Tennessee. The United States and the State of Tennessee alleged that Benchmark violated the federal False Claims Act and the Tennessee Medicaid False Claims Act by submitting claims to the TennCare program for physical therapythat were not reimbursable. Specifically, the governments' claim was that between 2001 and 2006, Benchmark submitted claims representing that it had provided therapeutic exercise for TennCare patients when medical records indicated that the patients had instead received aquatic therapy, a service subject to reimbursement restrictions. The United States also alleged that Benchmark submitted claims through the Medicare program for physical therapy services which did not qualify for payment or were not medically necessary. As a result of the settlement, Benchmark will pay $190,977.75 to the State of Tennessee and $1,625,489.25 to the United States. "These funds will compensate the Medicare and Medicaid trust funds and TennCare for moneys paid out of those funds which Benchmark improperly claimed and received during that time period," said U.S. Attorney Dedrick. "This settlement reflects our continued efforts to protect the trust funds supporting the Medicare, Medicaid and TennCare programs which provide crucial health care to our most vulnerable citizens."

U.S. Attorney Dedrick further noted that the settlement resulted from a comprehensive investigation which began in 2006. After an administrative subpoena was served on Benchmark in January 2008, Benchmark became aware of and began cooperating with the investigation including providing numerous patient charts and other Benchmark records. Benchmark has denied any wrongdoing in agreeing to the settlement. The investigation did not reveal patient quality of care concerns.

This joint investigation was conducted by the United States Attorney's Office, Eastern District of Tennessee, local Health Care Fraud Task Force members, the U.S. Department of Health and Human Services - Office of Inspector General (HHS-OIG) and the FBI. The Office of the Attorney General of the State of Tennessee and the Tennessee Bureau of Investigation also cooperated in the investigation and the resulting negotiated settlement. U. S. Attorney Dedrick commended the efforts of FBI Special Agent Anthony Tuggle, FBI Forensic Accountant Leann Lanz, and HHS-OIG Special Agent Tony Maffei for their roles in the investigation as well as Assistant United States Attorneys Kent Anderson and Betsy Tonkin who were responsible for the oversight of the civil investigation for the U. S. Attorney's Office.

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