Healthcare companies overbilling Medicare targeted by nonprofit whistleblowers group


http://www.healthcarefinancenews.com/news/healthcare-companies-overbilling-medicare-targeted-nonprofit-whistleblowers-group?mkt_tok=eyJpIjoiTlRJM01qYzNNekUzWkRNeCIsInQiOiJpNmdaaVhQY1hiamFJbVwvWFNjSGxPMXVYZ015RmRRUEVDVW9yaHRCNjhkRDBPamIxcTlhaGZvSUN2WTNoOTY4ZXhWZ0hxNVVmWFdWQTg0ejR2eDZCT0Z6UCtjVEw2UytxTGJYMUNiWnpnT0tiUUZzY0RWVjFmZW1cL1dFM2hLUzhGIn0%3D

The outreach was prompted by a Justice Department announcement in June that Genesis Healthcare would pay the federal government more than $53.6M.

The nonprofit Corporate Whistleblower Center is urging a medical doctor in any state to call them if they possess proof a healthcare company is substantially overbilling Medicare for hospice services for people who are not dying. The organization is also interested in hearing about skilled nursing or nursing homes facilities that are billing Medicare as if they are fully staffed when in fact they’re not.

The outreach was prompted by a Justice Department announcement in June that Genesis Healthcare would pay the federal government more than $53.6 million to settle lawsuits and investigations alleging that companies it acquired violated the False Claims Act — submitting false claims to government healthcare programs for medically unnecessary therapy and hospice services, and grossly substandard nursing care.

Allegedly the companies were also billing for hospice services for patients who weren’t terminally ill and were thus ineligible for the Medicare hospice benefit. The companies also allegedly billed inappropriately for certain physician evaluation management services.

Additionally, the settlement resolves allegations that Genesis and its affiliates violated certain essential requirements that nursing homes have to meet to participate in and receive reimbursements from government healthcare programs, and failed to provide sufficient nurse staffing to meet residents’ needs. The whistleblowers will receive a combined $9.67 million as their share of the recovery in this case.

The Corporate Whistleblower Center suspects that similar scenarios have the potential to occur in every state, whether it be a hospital admitting Medicare patients who should not have been admitted, a nursing home billing Medicare as if their Medicare patients are receiving the proper care when they’re not, or a hospice company signing up patients who are not dying.

The group advised potential whistleblowers not to approach the government first, or the news media. It offers help finding law firms to handle the information.

Potential whistleblowers can contact the Corporate Whistleblower Center at 866-714-6466 or at corporatewhistleblower.com.

 

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