A pair of Alabama consulting companies and nine nursing facilities affiliated with them have agreed to pay $10 million in fines to resolve allegations by the United States Justice Department that they submitted a raft of false claims to Medicare for medically unnecessary services.
Per federal investigators, Southern SNF Management, Inc., Rehab Services in Motion d/b/a Dynamic Rehab, and nine skilled nursing facilities in Florida and Alabama faced allegations made by former employees under the qui tam (whistleblower) provision of the False Claims Act (a/k/a the “Lincoln Law”) on an unspecified number of occasions by billing Medicare for rehabilitation therapy services that were not medically necessary.
The investigators say that, from the fall of 2009 through the end of 2013, these companies inflated certain patients’ Resource Utilization Group (RUG) levels, which is a metric used in the industry for quantifying the amount of skilled rehabilitation therapy a particular patient required. They allege that the firms’ corporate policies and practices encouraged such an inflation while ignoring the patients’ medical needs and desires.
The Justice Department did not disclose the amount of the $10 million in fines each of the accused firms agreed to pay.
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