A Pennsylvania health care firm has agreed to pay the Federal government over $15 million to settle claims that it defrauded Medicare and other government health care programs.
Prosecutors say the firm and its related companies intentionally overbilled Medicare by continuously billing at the highest level of reimbursement whether the services at that level of reimbursement were medically necessary or not.
The firm is accused of overbilling for Medicare at facilities in several states, including Pennsylvania, West Virginia, and Ohio. Investigators say the company began improperly billing to Medicare in early 2011 and continued through the end of 2017. The firm typically overbilled via prescribing medically unnecessary rehabilitation therapy services, they explained.
In addition to Medicare fraud allegations, the $15,466,280 payment will also extinguish charges relating to the firm’s employment of two individuals who are barred from federal healthcare programs. The firm voluntarily disclosed the information, admitting that it received inappropriate payments for billing for services rendered by the forbidden employees.
Though the charges are dismissed, the firm agreed to enter into a Corporate Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General. The agreement will encourage compliance by the firm via monitoring and auditing.
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