Considering that they work with clients who tend to be fragile and prone to accidents, nursing homes face heightened risks for negligence-based lawsuits. A comprehensive Assisted Living Professional Liability policy is absolutely critical to protecting these facilities’ financial interests. Recently, it was reported that a healthcare group settles for $125M from overbilling. Obviously, it’s critical that your clients perform due diligence when choosing third-party therapy providers with whom to partner.
Whistleblower Reports Company for Overbilling Medicare
In January, the U.S. Department of Justice announced the conclusion of a 5-year investigation into RehabCare, the country’s largest provider of skilled therapies. RehabCare and Kindred Healthcare Inc. (which purchased RehabCare in 2011) agreed to settle the lawsuit by paying $125 million for improper billing practices.
The lawsuit was brought by former RehabCare therapists Shawn Fahey and Janet Halpin. The pair alleged that RehabCare regularly booked assisted-living residents for therapies they did not need, that were never performed, or that supposedly were performed while patients were asleep. Additionally, the lawsuit alleged that RehabCare continued to schedule therapies for patients even after their doctors recommended that they be discharged. For their role in bringing the fraud to light, Fahey and Halpin will receive a $24 million portion of the settlement money. RehabCare continues to deny the allegations but says it settled to provide “clarity” for all parties involved.
Just the Tip of the Iceberg?
The January settlement is just the latest in a string of settlements involving alleged overbilling by RehabCare. In 2014, Maryland’s Episcopal Ministries to the Aging paid $1.3 million to settle allegations that it looked the other way as RehabCare overbilled Medicare. In 2015, assisted living company ArchCare paid $3.5 million and a Maine nursing home paid $1.2 to settle similar allegations related to RehabCare’s alleged inflated billing practices.
K&B Underwriters specializes in safeguarding nursing homes from the myriad risks they face each day. We offer an array of programs designed to mitigate assisted living facilities’ risks, control costs and minimize losses. Contact us at (855) 883-6306 to learn more.