Asbury Health Center, False Claims Act, Pennsylvania 2023

PITTSBURGH – Asbury Health Center, a continuing-care retirement community located in Pittsburgh, has agreed to pay the United States $1,331,837.96 to settle False Claims Act allegations, United States Attorney David J. Hickton announced today.

The settlement results from a self-disclosure by Asbury to the United States Attorney’s Office and Office of Inspector General of the Department of Health and Human Services concerning Medicare payments for skilled nursing facility services. For post-hospital skilled nursing care, Medicare regulations require that a facility obtain a physician certification at the time of admission or as soon thereafter as reasonable and practical. The facility must also obtain a physician recertification within 14 days of admission and every 30 days thereafter. Based on information provided by Asbury, the United States alleged that it had civil claims against Asbury resulting from Medicare payments for post-hospital skilled nursing services that were not supported by physician certifications and recertifications. The settlement resolves the matter without the filing of litigation.

This matter was investigated by the United States Attorney’s Office for the Western District of Pennsylvania and the Office of Inspector General of the Department of Health and Human Services. Assistant United States Attorney David Lew handled this matter on behalf of the United States.

The settlement is a significant development in the ongoing effort to ensure the integrity of Medicare programs in Western Pennsylvania. Asbury Health Center has a long history of providing quality care to its residents, and it is disappointing that the facility failed to meet the necessary standards in this instance.

The United States Attorney’s Office will continue to work tirelessly to protect the taxpayers of the Western District of Pennsylvania from those who would seek to defraud the system.

The case is a reminder that healthcare providers must follow strict guidelines and regulations to ensure the integrity of Medicare programs. Asbury Health Center’s self-disclosure and cooperation with the government demonstrate a commitment to transparency and accountability.

Asbury Health Center has agreed to pay $1,331,837.96 to settle the False Claims Act allegations. The settlement is a significant blow to the facility’s finances, and it serves as a warning to other healthcare providers that failure to comply with regulations can have serious consequences.

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