Nursing Home Operator and Director of Long Term Care to Pay $2.5 Million to Settle False Claims for Rehabilitation Therapy
BOSTON –Haverhill-based skilled nursing facility operator Whittier Health Network, Inc., and its Director of Long Term Care, Leo Curtin, have agreed to pay $2.5 million to resolve allegations concerning inflated Medicare claims.
The agreement announced today concerns rehabilitation therapy that Massachusetts-based Therapy Resources Management (TRM) purportedly provided at Whittier facilities in Massachusetts and New York. The settlement resolves allegations that Whittier and Mr. Curtin failed to take sufficient steps to prevent TRM from engaging in a pattern and practice of fraudulently inflating the reported amounts of therapy provided to Medicare Part A patients in Whittier facilities. Specifically, the facilities submitted bills for therapy that allegedly did not occur as reported, because the therapists were actually conducting initial evaluations when they claimed to be providing therapy. In addition, the therapists reported therapy time using estimates that often were rounded up from the actual minutes of therapy provided, despite Medicare rules specifically prohibiting the reporting of estimated or rounded numbers of minutes.
“This settlement and last week’s settlement with another TRM-served nursing home chain, Health Concepts, are the latest in a series of resolutions involving inflated Medicare billing at skilled nursing facilities,” said United States Attorney Carmen M. Ortiz. “We will continue our efforts to ensure that the provision of care in nursing facilities is based on patients’ clinical needs rather than the financial interests of the companies providing care.”
“Whittier Health Network put its financial gain ahead of the care of their patients,” said Harold H. Shaw, Special Agent in Charge of the Federal Bureau of Investigation, Boston Field Division. “The FBI will continue to aggressively investigate skilled nursing facilities that inflate their billing and exploit the nation’s healthcare system.”
“Patients and taxpayers rightly expect nothing less than suitable, high-quality health care,” said Phillip M. Coyne, Special Agent in Charge, Office of Inspector General of the U.S. Department of Health and Human Service’s Boston Regional Office. “Providers more concerned with increasing Medicare profits, though, can expect my agency working with law enforcement partners to aggressively investigate and prosecute.”
HHS Hotline. The government encourages anyone with information about the practices described above, or similar practices involving rehabilitation therapy in nursing facilities, to contact the Department of Health and Human Services Office of Inspector General Hotline via telephone, 1-800-HHS-TIPS (1-800-447-8477), or in writing via https://forms.oig.hhs.gov/hotlineoperations/.
This matter was investigated by the Department of Health and Human Services, Office of the Inspector General; the Federal Bureau of Investigation; and the Department of Veterans Affairs, Office of Inspector General. The case was handled by Assistant U.S. Attorney Gregg Shapiro of Ortiz’s Affirmative Civil Enforcement Unit.