27 Skilled Nursing Facilities Controlled by Longwood Management Corp. to Pay $16.7 Million to Resolve Allegations of Inflated Medicare Bills
The DOJ announced on July 13, 2020 that Longwood Management Corporation and 27 affiliated skilled nursing facilities (Longwood) – agreed to settled complaints that they submitted false claims to Medicare for rehabilitative services that weren’t reasonable or necessary. The complaints were filed pursuant to the federal False Claims Act. Longwood is based in Los Angeles, California. The 27 facilities are located in Southern California.
The assertions, according to a US attorney, were that Longwood pressured therapists to provide additional, unnecessary services – when the facilities didn’t meet their targets. Of significance is that the case was brought by a whistleblower. The FCA permits whistleblowers to file disclosures of fraudulent activity. If valid disclosures lead to a recovery, the whistleblower is entitled to a sizable portion of the recovery. Recoveries include repayment of false bills and statutory damages. The two whistleblowers were awarded $3,006,000 for their disclosures.
Medicare reimburses nursing facilities at a rate that reflects the “skilled therapy and nursing needs of qualifying patients.” The stronger the patient’s needs are – the higher the reimbursement rate is. “Ultra High” is the highest reimbursement rate for Medicare. Ultra High applies if therapy patients require at least 720 minutes (12 hours) of skilled therapy from “two therapy disciplines (e.g., physical, occupational or speech therapy), one of which has to be offered five days a week.”
Longwood was accused of pressuring therapists to order amounts of care that would qualify for the Ultra High level. The conduct was alleged to have occurred between 2008 and 2012 at six difference facilities. Another 21 facilities were alleged to have committed such wrongful upgrades between 2006 and 2014.
In addition to the financial settlement, Longwood agreed to enter int a five-year Corporate Integrity
At the California Law Offices of Stephen A. Danz and Associates, we represent whistleblowers who file healthcare, defense contracting, tax, and other types of governmental fraud claims. We work to obtain your fair percentage of any recovery. To discuss a whistleblower claim today, phone us at 877-789-9707 or use our online contact form to make an appointment. Se habla espanol.