Feds Recover $30mm: Claim Skilled Nursing Facilities Billed for Unnecessary Rehab Therapy

California’s Orange County-based North American Health Care Inc. (NAHC) has agreed to pay the U.S. government $28.5 million to resolve long-running allegations it billed Medicare and TRICARE for medically unnecessary rehabilitation therapy services in violation of federal and state False Claims Acts. NAHC’s senior vice president of reimbursement analysis and chairman of the board will pay an additional $1.5 million, the Department of Justice announced today.

California North American Health Care Alleged False Claims Act Violations

False Claims Act and other charges claim NAHC’s inpatient skilled nursing facilities subjected its residents to unnecessary occupational, physical and speech therapy sessions while the government footed the bill. The private, for-profit company operates 35 facilities across California, billing Medicare and California Medicaid (Medi-Cal) for eligible services. For services to be eligible for payment, however, they must be “reasonable and necessary for the diagnosis or treatment of illness or injury.”...

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