Traverse City Physical Therapy And Home Health Practices Resolve Civil Liability For Alleged Healthcare Fraud Against The United States
For Immediate Release
U.S. Attorney's Office, Western District of Michigan
GRAND RAPIDS – Traverse City-based Defendants Great Lakes Therapy Housecalls, P.C., Great Lakes Home Healthcare Specialists, LLC, and their owner, James A. Harvey, have agreed to pay $450,000 to resolve allegations that they violated the False Claims Act by submitting false claims for reimbursement to the Medicare Program.
This settlement resolves allegations set forth in a complaint filed earlier this year by the United States in the U.S. District for the Western District of Michigan. The United States brought this case, captioned United States v. Harvey, et al., No. 1:21-cv-442, under the False Claims Act, which entitles the government to collect up to treble the amount of damages caused by a defendant, as well as civil penalties for each violation.
In the complaint, the United States alleged that the Defendants submitted hundreds of false claims to the government by knowingly billing Medicare for additional units of physical and occupational therapy services that they never provided. Additionally, the United States alleged that the Defendants falsely submitted claims for physical therapy services under the name of an employee while she was on maternity leave, knowingly hired an unqualified person as a medical social worker and billed Medicare for episodes of care provided to homebound Medicare beneficiaries that included this individual’s services, and altered the dates of physician signatures on certifications of beneficiary eligibility for home health services.
In September 2021, the United States also reached a civil settlement with Daniel R. McGoran, the former office manager at Great Lakes Therapy Housecalls, for his role in the fraud scheme involving billing additional units of physical and occupational therapy. Mr. McGoran agreed to pay the United States $75,071.
“Lying to the government when seeking Medicare reimbursement and falsifying patient records cheats taxpayers everywhere who support the Medicare Program,” said U.S. Attorney Andrew Birge. “My office will come after false billing like that not only for the civil penalties but also for the treble damages as well to deter future cheating.”
“When medical providers increase profits by submitting false claims to Medicare, they unjustly enrich themselves and undermine the public’s trust in the medical profession,” said Special Agent in Charge Mario M. Pinto of the U.S. Department of Health and Human Services Office of Inspector General (“HHS-OIG”). “We will continue to work diligently with our law enforcement partners to protect the integrity of Medicare and the beneficiaries served by such federal health care programs.”
The resolutions obtained in this matter were the result of a coordinated effort between the U.S. Attorney’s Office for the Western District of Michigan, HHS-OIG, and the Federal Bureau of Investigation. Assistant U.S. Attorneys Andrew J. Hull and Ryan D. Cobb represented the United States.
The claims resolved by this settlement are allegations only and there has been no determination of liability.
Updated November 3, 2021
Health Care Fraud