Nursing home chain to pay $2.7M to settle overbilling charges

Two Tennessee nursing home firms have agreed to pay the federal government at least $2.7 million to settle charges of overbilling the Medicare and Medicaid programs for rehabilitation therapy, reported the Chattanooga Times-Free Press.

Grace Healthcare LLC and Grace Ancillary Services LLC violated the U.S. False Claims Act when they billed Medicare and the TennCare program for unnecessary speech, physical and vocational therapy provided at 10 nursing homes between 2007 and 2011, according to the U.S. Justice Department.

Prosecutors allege Grace employees had been pressured to provide excessive therapy services to meet corporate targets for Medicare revenue.

"Healthcare providers must make decisions regarding the level of services to be provided based solely on individual patient need rather than a desire to increase the bottom line," Bill Killian, U.S. Attorney for the Eastern District of Tennessee said Friday in a statement.

In addition to the penalty and interest payments, Grace Healthcare and its affiliate also agreed to ongoing monitoring by the U.S. Department of Health & Human Services' Office of the Inspector General as part of a corporate integrity agreement.

The settlement stemmed from whistleblowing employee. Since May 2009, when it launched a joint initiative with HHS to crack down on billing fraud, the DoJ has recovered more than $10 billion from busted healthcare fraud schemes.

For more:
- read the Times-Free Press article
- read the DoJ statement