The Department of Justice has filed a consolidated complaint against HCR ManorCare (ManorCare), headquartered in Toledo, Ohio, alleging that the company billed patients for unnecessary treatment.
After the filing of three False Claims Act lawsuits, the government decided to step in and file a complaint against the short-and-long-term care provider alleging that the company knowingly submitted false claims to Medicare and Tricare for rehabilitation therapy services that were not medically necessary.
The Department of Justice is committed to ensuring that healthcare providers who pressure their employees to provide medically unnecessary services to Medicare beneficiaries and Tricare recipients solely to increase their own profits are held accountable, Principal Deputy Assistant Attorney General Benjamin C. Mizer said in an online statement.
The government claims that ManorCare also set billing goals to increase revenues without taking into account their patients clinical needs. Additionally, the company allegedly threatened to dismiss managers and therapists if they did not provide additional treatments that would qualify for the highest Medicare payments.
Finally, the government also alleges that ManorCare increased Medicare payments by keeping patients in their facilities for longer than necessary.
Three whistleblower lawsuits were filed in the Eastern District of Virginia under the provisions of the False Claims Act. The initial accusations against the company were filed by a northern Virginia occupation therapist six years ago.
According to the government, a robust investigation on alleged false billings was completed before the consolidated claim was filed. One item of interest the investigation revealed was that in three years the top reimbursement rate billed to Medicare tripled at ManorCare facilities.
ManorCare operates more than 281 nursing facilities in 30 states, dozens of their facilities are located in Ohio. If found viable for False Claims Act violations, the company may be forced to pay three times the governments losses plus civil penalties.
If you believe that your loved was given unnecessary treatment while at a ManorCare facility, you may be entitled to file a nursing home abuse claim.