by Ben Vernia | June 11th, 2018
On June 8, the Department of Justice announced that Kentucky-based Signature HealthCARE, LLC, a skilled nursing facility company, had agreed to pay more than $30 million to resolve federal and state claims that the company defrauded the Medicare program. According to DOJ’s press release:
Signature HealthCARE, LLC (Signature), a Louisville, Kentucky based company that owns and operates approximately 115 skilled nursing facilities, including 7 in middle Tennessee, has agreed to resolve allegations that it violated the False Claims Act by knowingly submitting false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary and skilled, the Department of Justice announced today. The settlement also resolves allegations that Signature submitted forged pre-admission certifications of patient need for skilled nursing to the state of Tennessee’s Medicaid program. Under the settlement agreements, Signature has agreed to pay more than $30 million. As part of the resolution, the State of Tennessee will receive a portion of the overall settlement.
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The government alleged that Signature engaged in various practices that resulted in the submission of claims for unreasonable, unnecessary, and unskilled services to Medicare patients, including: (1) presumptively placing patients in the highest therapy reimbursement level, rather than relying on individualized evaluations to determine the level of care most suitable for each patient’s clinical needs; (2) providing the minimum number of minutes required to bill at a given reimbursement level while discouraging the provision of additional therapy beyond that minimum threshold; and, (3) pressuring therapists and patients to complete the planned minutes of therapy even when patients were sick or declined to participate in therapy.
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The relators’ share of the settlement has not yet been announced.
