Government Sues ManorCare for Providing Unnecessary Therapy ManorCare—operator of approximately 281 skilled nursing facilities (SNFs) in 30 states—submitted false claims to Medicare and Tricare (the armed services health care program) for rehabilitation therapy services that were not medically reasonable and necessary, alleges a federal government complaint. The complaint alleges that: In filing its complaint, the government has ... News in Brief
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News in Brief  |   June 01, 2015
Government Sues ManorCare for Providing Unnecessary Therapy
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Regulatory, Legislative & Advocacy / News in Brief
News in Brief   |   June 01, 2015
Government Sues ManorCare for Providing Unnecessary Therapy
The ASHA Leader, June 2015, Vol. 20, 9. doi:10.1044/leader.NIB3.20062015.9
The ASHA Leader, June 2015, Vol. 20, 9. doi:10.1044/leader.NIB3.20062015.9
ManorCare—operator of approximately 281 skilled nursing facilities (SNFs) in 30 states—submitted false claims to Medicare and Tricare (the armed services health care program) for rehabilitation therapy services that were not medically reasonable and necessary, alleges a federal government complaint.
The complaint alleges that:
  • Because of the pressure ManorCare placed on SNF administrators and rehabilitation therapists to meet unrealistic financial goals, patients received services that were medically unreasonable and unnecessary.

  • ManorCare set billing goals to significantly increase revenues without regard to patients’ clinical needs, and threatened to terminate SNF managers and therapists who didn’t provide the additional treatments necessary to qualify for the highest Medicare payments.

  • To increase its Medicare payments, ManorCare kept patients in its facilities even though they were medically ready to be discharged.

In filing its complaint, the government has intervened in and consolidated three whistleblower False Claims Act lawsuits, which allow private parties to sue for false claims for government funds and to receive a share of any recovery. Violators are liable for three times the government’s losses plus civil penalties.
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FROM THIS ISSUE
June 2015
Volume 20, Issue 6