Extended nursing home care has become huge business in the recent decades due to people living longer and federal funding for care, and Life Care Centers of America (Life Care) has been there nearly from the start in cashing in on the nursing home boom. Founded in 1970 by Forrest Preston in Tennessee, Life Care now operates nursing homes in 28 states and employees 42,000 people, still under the leadership of Preston, who has amassed a net worth of $1.4 billion. A recent settlement in a 4-year False Claims Act (FCA) lawsuit brought by the Department of Justice (DOJ) would suggest that at least some of that wealth was based on ill-gotten gains, and, as a result of the settlement, Life Care will be paying $145 million in fines to in connection with alleged false claims submitted to the government for Medicare and TRICARE rehabilitation therapy services. This is the largest fine ever imposed on a skilled nursing facility.
The DOJ’s 7-Year Investigation into Life Care’s Fraudulent Billing
The DOJ investigated Life Care’s business practices from 2006 through 2013 and found that the company was systematically incorporating procedures intended to defraud the federal government (and indirectly all federal taxpayers) by providing false descriptions of what types of rehabilitation therapy patients needed and keeping patients in their facilities longer than necessary in order to collect higher reimbursements. Medicare reimbursements are made to facilities based on the type of care provided, with higher reimbursements for work requiring higher skills and more time commitment. Life Care fraudulently set in place procedures which resulted in the company consistently submitting claims for “Ultra High” physical therapy reimbursement despite the fact that many patients did not need the care and/or therapists believed that the care should be ended.
Two Whistleblowers to Share in $29 Million Award
The FCA suits providing the information which led to the $145 million settlement were originally filed by two former Life Care employees, Tammie Taylor and Glenda Martin. The federal government later intervened in the cases after examining the evidence asserted in those initial cases. For their part in bringing forth evidence of Life Care’s fraud, Taylor and Martin will share a $29 million reward. In announcing the award, the DOJ affirmed its dedication to fighting fraud in federal healthcare reimbursement, pointing out that it has recovered nearly $20 billion since 2009 in cases involving federal health care fraud.
How You Can Be Rewarded for Exposing Medicare/Medicaid Fraud
Any person with knowledge of false claims being submitted to the federal government has the potential to bring an FCA claim and share in the recovery collected due to a wrongdoer’s fraud. By working with an experienced whistleblower attorney knowledgeable in the FCA process, you can maximize your chances for success and the highest recovery possible. At Kreindler & Associates, our experienced healthcare fraud attorneys will work with you every step of the way to determine your appropriate course of action, protect you from retaliation, and collect your much-deserved reward. If you suspect that someone is committing Medicare fraud, contact us today for an evaluation of your allegations.
