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Medicare Scam Exposed: $2M Fine for Interface Rehab
LOS ANGELES – In a shocking case of Medicare scam, Interface Rehab, a Placentia-based rehabilitation therapy company, has agreed to pay $2 million to resolve allegations that it caused the submission of false 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 Rehab 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, including 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 allegations, Interface Rehab pressured therapists to increase the amount of therapy provided to patients in order to meet pre-planned targets for Medicare revenue. This allegedly led to billing for a high percentage of patients at the “Ultra High” level without regard to patients’ individualized needs.
“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. “This case is further proof that the government will vigorously pursue those who attempt to cheat the taxpayer-funded system that pays for medical care for millions of Americans, sometimes with the help of whistleblowers who shine a light on fraud.”
“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 Department of Justice’s Civil Division. “Rehabilitation therapy companies provide important services to our vulnerable elderly population, but they will be held to account if they provide therapy services based on maximizing revenue rather than the interests of their patients.”
“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). “We will not tolerate such fraud schemes, which undermine medical decision-making and the public’s trust in the health profession.”
This case is part of a larger pattern of Medicare scam cases, including a 2020 settlement where Longwood Management Corporation and 27 affiliated skilled nursing facilities agreed to pay $16.7 million to the United States to resolve allegations that they violated the False Claims Act by submitting false claims to Medicare for rehabilitation therapy services that were not reasonable or necessary.
Key Facts
- State: California
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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