ALBANY, NEW YORK – In a stunning revelation, Strauss Ventures LLC, operating as The Grand Health Care System, and its twelve affiliated skilled nursing facilities have been hit with a $21.3 million fine for allegations of fraudulent billing. The federal government accused the Grand of systematically overbilling federal healthcare programs by charging for therapy services that were either unnecessary, unskilled, or didn’t happen at all.
The settlement, which spans from January 1, 2014, to September 30, 2019, involves Medicare Part A and TRICARE. The Grand was accused of submitting bills for more therapy than was reasonable or necessary, sometimes billing for services that were never provided. Several facilities in upstate and central New York were implicated, including locations in Albany, Oneida, Madison, Columbia, and Herkimer counties.
United States Attorney Carla B. Freedman emphasized the importance of ensuring medical treatment is patient-driven rather than financially motivated. ‘We will continue to hold skilled nursing facilities accountable when they provide patients with unnecessary services and falsify records,’ she said.
The Grand admitted that former management level employees set quotas for therapy sessions, leading to over-scheduling and prolonged stays. The company also acknowledged instances where supervisors falsified the number of therapy minutes recorded in their electronic system. ‘We expect nursing facilities to provide only reasonable and appropriate amounts of skilled rehabilitation therapy service,’ said Principal Deputy Assistant Attorney General Brian Boynton.
In addition to federal healthcare programs, the Grand also faced Medicaid fraud allegations for services rendered at its Pawling, New York facility between January 1, 2016, and June 30, 2021. The inflated reimbursement rates were based on inaccuracies reflecting the level of care provided.
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Key Facts
- State: New York
- Agency: DOJ USAO
- Category: Fraud & Financial Crimes
- Source: Official Source ↗
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