Fraud Verdict May Cost Skilled Nursing Facility Operators $345 Million The operators of 53 skilled nursing facilities (SNFs) will likely have to pay $345 million in damages and penalties related to false Medicare and Medicaid claims, the result of a Florida federal jury trial. In this whistleblower suit under the False Claims Act, the jury found the SNF operators liable ... News in Brief
Free
News in Brief  |   May 01, 2017
Fraud Verdict May Cost Skilled Nursing Facility Operators $345 Million
Author Notes
Article Information
Special Populations / Older Adults & Aging / Healthcare Settings / News in Brief
News in Brief   |   May 01, 2017
Fraud Verdict May Cost Skilled Nursing Facility Operators $345 Million
The ASHA Leader, May 2017, Vol. 22, 8. doi:10.1044/leader.NIB1.22052017.8
The ASHA Leader, May 2017, Vol. 22, 8. doi:10.1044/leader.NIB1.22052017.8
The operators of 53 skilled nursing facilities (SNFs) will likely have to pay $345 million in damages and penalties related to false Medicare and Medicaid claims, the result of a Florida federal jury trial.
In this whistleblower suit under the False Claims Act, the jury found the SNF operators liable for more than $115 million in damages. The False Claims Act calls for triple damages plus penalties, perhaps boosting the liability to $345 million.
The defendants in the case (U.S. ex rel. Ruckh v. CMC II LLC et al, case number 8:11-cv-01303, in the U.S. District Court for the Middle District of Florida) were CMC II LLC, Salus Rehabilitation LLC, 207 Marshall Drive Operations LLC and 803 Oak Street Operations LLC.
Because the False Claims Act carries such high penalties, defendants in most cases choose to settle out of court, rather than going to trial.
As in the cases recently settled out of court, the defendants in this case were accused of artificially increasing the amount of resources patients need (including nursing and rehabilitation services) to receive more reimbursement from Medicare and Medicaid. This practice, known as upcoding, is a top area of concern of the U.S. Department of Health and Human Services’ Office of the Inspector General.
0 Comments
Submit a Comment
Submit A Comment
Name
Comment Title
Comment


This feature is available to Subscribers Only
Sign In or Create an Account ×
FROM THIS ISSUE
May 2017
Volume 22, Issue 5