Nursing home operator Ensign Group, Inc. has agreed to pay $48 million to resolve allegations that it billed Medicare for unnecessary rehabilitation therapy services.
These False Claims Act lawsuits involved billing for services provided at six skilled nursing facilities operated by Ensign in California. According to the whistleblowers’ allegations, Ensign provided medically unnecessary therapy to patients, and billed Medicare for services it had not provided. The government also contended that Ensign improperly incentivized its employees to increase the amount of therapy provided to Medicare patients regardless of the patients’ individual therapy needs.
The whistleblowers who filed these lawsuits, two therapists formerly employed with Ensign, will share in the settlement proceeds pursuant to the qui tam provisions of the False Claims Act. The amount of the whistleblowers’ share has not been announced.
For more information on this case, click here: http://www.justice.gov/opa/pr/2013/November/12-civ-1235.html