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California Rehab Center Faces $2 Million Fine for Medicare Scam
Interface Rehab, a California-based rehabilitation therapy company, has agreed to pay $2 million to resolve allegations that it violated the False Claims Act by causing the submission of claims to Medicare for rehabilitation therapy services that were not reasonable or necessary.
The settlement resolves allegations that, from January 1, 2006, through October 10, 2014, Interface knowingly submitted or caused the submission of false claims for medically unreasonable and unnecessary “Ultra High” levels of rehabilitation therapy for Medicare Part A residents at 11 Skilled Nursing Facilities in California.
These facilities include Colonial Care Center, Covina Rehabilitation Center, Crenshaw Nursing Home, Green Acres Lodge, Imperial Care Center, Laurel Convalescent Hospital, Live Oak Rehabilitation Center, Longwood Manor Convalescent Hospital, Monterey Care Center, San Gabriel Convalescent Center, and Whittier Pacific Care Center.
According to the United States, Interface pressured therapists to increase the amount of therapy provided to patients in order to meet pre-planned targets for Medicare revenue. These alleged targets could only be achieved by billing for a high percentage of patients at the “Ultra High” level without regard to patients’ individualized needs.
“This settlement reflects our continuing efforts to protect patients and taxpayers by ensuring that the care provided to beneficiaries of government-funded health care programs is dictated by clinical needs, not a provider’s fiscal interests,” said Acting Assistant Attorney General Brian M. Boynton for the Civil Division.
“The claims that patients required ultra-high levels of care appear to be driven solely by a desire to send ultra-high bills to Medicare,” said Acting U.S. Attorney Tracy L. Wilkison for the Central District of California.
“Our agency will continue to aggressively investigate health care providers that attempt to boost their profits by falsely billing federal health care programs for medically unnecessary services,” said Special Agent in Charge Timothy B. DeFrancesca of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG).
Defendant: Interface Rehab
Criminal Charges: Violating the False Claims Act by causing the submission of claims to Medicare for rehabilitation therapy services that were not reasonable or necessary.
City and State: California
Exact Date: January 1, 2006, through October 10, 2014
Sentence or Outcome: Interface Rehab agreed to pay $2 million to resolve the allegations.
Dollar Amounts: $2 million
Key Facts
- State: California
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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