{"id":43463,"date":"2021-07-23T09:13:12","date_gmt":"2021-07-23T16:13:12","guid":{"rendered":"https:\/\/cjnotebook.com\/?p=43463"},"modified":"2021-07-23T09:13:12","modified_gmt":"2021-07-23T16:13:12","slug":"interface-rehab-to-pay-2-million-for-allegedly-claiming-unnecessary-and-unreasonable-medicare-services","status":"publish","type":"post","link":"https:\/\/cjnotebook.com\/?p=43463","title":{"rendered":"Interface Rehab to Pay $2 Million for Allegedly Claiming Unnecessary and Unreasonable Medicare Services"},"content":{"rendered":"

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0LOS ANGELES\u00a0<\/strong><\/span><\/p>\n

Interface Rehab, headquartered and operating in Orange County, agreed to pay $2 million to resolve allegations that it violated the False Claims Act by submitting claims to Medicare, officials announced Friday.<\/span><\/p>\n

\"\"<\/a><\/p>\n

The rehabilitation therapy services were not reasonable or necessary, according to authorities.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The settlement resolves allegations that, from January 1, 2006, through October 10, 2014, the Placentia-based Interface knowingly submitted or caused the submission of false claims for medically unreasonable and unnecessary \u201cUltra High\u201d levels of rehabilitation therapy for Medicare Part A residents at 11 Skilled Nursing Facilities. <\/span><\/p>\n

These facilities include Colonial Care Center, Covina Rehabilitation Center, Crenshaw Nursing Home, Green Acres Lodge, Imperial Care Center, Laurel Convalescent Hospital, Live Oak Rehabilitation Center, Longwood Manor Convalescent Hospital, Monterey Care Center, San Gabriel Convalescent Center, and Whittier Pacific Care Center. <\/span><\/p>\n

\"\"<\/a>
Medicare<\/figcaption><\/figure>\n

In July 2020, the Department of Justice\u00a0announced<\/a>\u00a0that Longwood Management Corporation and 27 affiliated skilled nursing facilities agreed to pay $16.7 million to the United States to resolve allegations that they violated the False Claims Act by submitting false claims to Medicare for rehabilitation therapy services that were not reasonable or necessary. <\/span><\/p>\n

The settlement announced today resolves Interface\u2019s role in that alleged conduct.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 During the relevant time period, Medicare reimbursed skilled nursing facilities at a daily rate that reflected the skilled therapy and nursing needs of qualifying patients. <\/span><\/p>\n

The greater the patient\u2019s needs, the higher the level of Medicare reimbursement. <\/span><\/p>\n

\"\"<\/a>The highest level of Medicare reimbursement for skilled nursing facilities was for \u201cUltra High\u201d therapy patients, who required a minimum of 720 minutes of skilled therapy from two therapy disciplines (e.g., physical, occupational, or speech therapy), one of which had to be provided five days a week.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The federal government contends that Interface pressured therapists to increase the amount of therapy provided to patients in order to meet pre-planned targets for Medicare revenue. <\/span><\/p>\n

These alleged targets could only be achieved by billing for a high percentage of patients at the \u201cUltra High\u201d level without regard to patients\u2019 individualized needs.<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u201cThe claims that patients required ultra-high levels of care appear to be driven solely by a desire to send ultra-high bills to Medicare,\u201d said Acting U.S. Attorney Tracy L. Wilkison for the Central District of California.\u00a0<\/span><\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u201cThis settlement reflects our continuing efforts to protect patients and taxpayers by ensuring that the care provided to beneficiaries of government-funded health care programs is dictated by clinical needs, not a provider\u2019s fiscal interests,\u201d said Acting Assistant Attorney General Brian M. Boynton for the Department of Justice\u2019s Civil Division. \u201cRehabilitation therapy companies provide important services to our vulnerable elderly population, but they will be held to account if they provide therapy services based on maximizing revenue rather than the interests of their patients.\u201d<\/span><\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0The allegations were brought under whistleblower provisions under federal law.<\/span><\/p>\n

Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery. The whistleblower will receive $360,000 of the settlement proceeds. <\/span><\/p>\n

The qui tam case is captioned United States ex rel. Pennetti v. Interface Rehab, et al.<\/i>, No. CV-14-4133 (C.D. Cal.).<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0LOS ANGELES\u00a0 Interface Rehab, headquartered and operating in Orange County, agreed to pay $2 million to resolve allegations that it violated the False Claims Act by submitting claims to Medicare, officials announced…<\/p>\n","protected":false},"author":1,"featured_media":43464,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3255,3],"tags":[],"class_list":["post-43463","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-federal-court","category-u-s-department-of-justice"],"yoast_head":"\nInterface Rehab to Pay $2 Million for Allegedly Claiming Unnecessary and Unreasonable Medicare Services<\/title>\n<meta name=\"description\" content=\"\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0LOS ANGELES\u00a0 Interface Rehab, headquartered and operating in Orange County, agreed to pay $2 million to resolve allegations that it violated the\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/cjnotebook.com\/?p=43463\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Interface Rehab to Pay $2 Million for Allegedly Claiming Unnecessary and Unreasonable Medicare Services\" \/>\n<meta property=\"og:description\" content=\"\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0LOS ANGELES\u00a0 Interface Rehab, headquartered and operating in Orange County, agreed to pay $2 million to resolve allegations that it violated the\" \/>\n<meta property=\"og:url\" content=\"https:\/\/cjnotebook.com\/?p=43463\" \/>\n<meta property=\"og:site_name\" content=\"American Justice Notebook\" \/>\n<meta property=\"article:publisher\" 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