ATLANTA — New London Health Center will pay $400,000 over allegations that they knowingly submitted false claims to Medicare, according to the U.S. Department of Justice.
New London submitted claims for rehabilitation therapy services that "were not reasonable, necessary, and skilled," according to a news release.
The settlement amount was based on New London’s ability to pay.
“Nursing home facilities provide important services to our elderly; however, those facilities must uphold the trust placed in them by billing the government only for reasonable and necessary services,” U.S. Attorney Kurt Erskine said in a news release.
Between January 2011 and November 2014, New London placed patients in an 'Ultra High' therapy reimbursement level rather than seeking guidance from individualized evaluations to determine care for patients, investigators said.
Patients were given the minimum minutes required to charge at that reimbursement level and then discouraged additional therapy beyond that threshold, according to attorneys.
The attorneys added that New London ramped up therapy minutes after billing levels were set and pressured therapists and patients to complete planned minutes of therapy regardless of their needs.
These actions violated the U.S. False Claims Act, according to prosecutors.
The claims resolved by this settlement are still allegations as there has been no determination of liability.
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