BANGOR, Maine — Nursing home Ross Manor has agreed to pay $1.2 million to settle allegations it allowed a vendor to inflate Medicare claims for rehabilitation therapy.
The Boston U.S. attorney’s office announced the settlement Monday, alleging Ross Manor failed to prevent a subcontractor from submitting claims to Medicare seeking reimbursement for “unreasonable or unnecessary” therapy.
The subcontractor, RehabCare Group East Inc., a subsidiary of Kindred Healthcare Inc., employs Ross Manor’s physical therapists. The company billed the government for inappropriately high levels of therapy in order to receive maximum payments, the U.S. attorney’s office alleged.
“This settlement is the latest in a series of resolutions involving Medicare billing for rehabilitation therapy at skilled nursing facilities,” U.S. attorney Carmen Ortiz said in the release. “We will continue our work to ensure that the provision of care in skilled nursing facilities is based on patients’ clinical needs and not tied to the financial targets of the companies providing their care.”
RehabCare Group East was part of a similar settlement in Massachusetts in September 2014 and was named in a $30 million settlement in January 2014 related to an alleged kickback scheme for the referral of nursing home business in Minnesota and Missouri.
Ross Manor is owned by First Atlantic Corporation and Rosscare Nursing Homes Inc., a division of Eastern Maine Healthcare Systems.
Ross Manor has reviewed its procedures and instituted new measures to improve its oversight of vendors, EMHS Chief Communications Officer Suzanne Spruce said in a statement.
“Ross Manor is pleased this matter has been resolved and appreciates the cooperation of the U.S. attorney’s office,” Spruce said. “Throughout this matter, Ross Manor has worked with the government to understand where it can exercise more oversight of the billing and record keeping practices of its contractors.”
