Select Medical & Encore to Pay $ 8 Million to Settle FCA Claims –
Select Medical, Encore resolves government claims that Select Medical Rehabilitation Services billed Medicare for medically unnecessary services.
Select Medical Corporation and Encore GC Acquisition LLC will pay more than $ 8 million to resolve allegations that Select Medical Rehabilitation Services Inc. (SMRS) violated the False Claims Act (FCA). The FCA is a measure that prohibits any person or business from knowingly submitting fraudulent payment requests to the government. Select Medical operates long-term acute care and inpatient rehabilitation hospitals. From 1997 to 2016, according to the DOJ, SMRS offered contracted rehabilitation therapy services to Qualified Nursing Facilities (SNFs), and from January 2010 to 2016, SMRS contracted a dozen SNFs in New York and the rest of the world. New Jersey to provide rehabilitation therapy. Select Medical was the former parent company of SMRS and Encore is the successor in the interest of SMRS.
The resolution comes just two months after it was announced that SavaSeniorCare would pay $ 11 million to address FCA’s claims that its policies and procedures pressure staff to charge for “medically unreasonable, unnecessary or unqualified services. Provided to Medicare patients. SavaSeniorCare, based in Georgia with SNFs staffed at facilities across the country, asked SNFs to bill the government program for rehabilitative therapy services that “were not reasonable, necessary or qualified.” As a member of resolution, Sava also has a five-year corporate integrity agreement with the United States Office of the Inspector General of Health and Human Services (HHS-OIG) that requires an independent reviewer to monitor each year. patient stays and Medicare related claims.
“When corporate greed reaches the level of federal health care fraud programs, while subjecting one of our most vulnerable populations to substandard care and unnecessary medical services, we must hold businesses to account, ”said Acting U.S. Attorney Mary Jane Stewart for the Central District of Tennessee. “Any fraud that compromises the care of elderly nursing home residents cannot continue and will be exposed and uprooted. We are grateful to the courageous whistleblowers who reported this blatant conduct. “
Acting Assistant Attorney General Brian M. Boynton added of the latest agreement: “Today’s settlement reflects our commitment to protect patients and taxpayers by ensuring that the care provided to Medicare beneficiaries be driven by their individual clinical needs and not by the financial interests of a provider. Contracted rehabilitation therapy companies, like other health care providers, will be held accountable if they knowingly provide unnecessary services to patients that wastes taxpayer dollars. “
“Qualified residents of nursing homes and their families need to be assured that the care and therapy residents receive is based on medical need, not greed,” Acting U.S. Attorney Rachael A. Honig said for the District of New Jersey. “We also need to protect taxpayers by ensuring that Medicare only pays the costs services performed for legitimate medical purposes. We will hold all healthcare providers who break the false claims law accountable for their actions. “
A spokesperson for Encore responded that he had only accepted the settlement as a successor in title, clarifying his position by stating: “Although Encore has no involvement in the alleged conduct, we have agreed to enter into a settlement with the government – with Select – to resolve the issue, as we are considered the “successor in the best interests” of SMRS due to the acquisition. “