False Medicare Claims Cost Nursing Facility Operator $30 Million North American Health Care Inc. (NAHC), which operates 35 skilled nursing facilities, its chairman of the board and its senior vice president of reimbursement analysis have agreed to pay a total of $30 million to resolve allegations that they submitted false claims to Medicare and TRICARE for medically unnecessary speech-language, ... News in Brief
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News in Brief  |   December 01, 2016
False Medicare Claims Cost Nursing Facility Operator $30 Million
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Special Populations / Older Adults & Aging / Healthcare Settings / Practice Management / News in Brief
News in Brief   |   December 01, 2016
False Medicare Claims Cost Nursing Facility Operator $30 Million
The ASHA Leader, December 2016, Vol. 21, 12. doi:10.1044/leader.NIB4.21122016.12
The ASHA Leader, December 2016, Vol. 21, 12. doi:10.1044/leader.NIB4.21122016.12
North American Health Care Inc. (NAHC), which operates 35 skilled nursing facilities, its chairman of the board and its senior vice president of reimbursement analysis have agreed to pay a total of $30 million to resolve allegations that they submitted false claims to Medicare and TRICARE for medically unnecessary speech-language, physical and occupational therapy services to residents of its facilities.
NAHC is a private, for-profit company headquartered in Orange County, California. NAHC skilled nursing facilities (SNFs)—most of which are in California—provide inpatient rehabilitation services to patients. Under the settlement agreement, NAHC pays $28.5 million; the reimbursement vice president, who the U.S. Department of Justice contends created the improper billing scheme, pays $500,000; and the board chair, who reinforced the scheme at NAHC facilities, pays $1 million.
As part of the settlement, NAHC has also signed a five-year Corporate Integrity Agreement with the Office of the Inspector General in the Department of Health and Human Services. The agreement applies to all NAHC-managed SNFs and requires an independent review of therapy services billed to Medicare.
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FROM THIS ISSUE
December 2016
Volume 21, Issue 12