Federal and state prosecutors are targeting companies who fraudulently bill Medicare and Medicaid for unqualified patients for skilled nursing and rehabilitation services under Medicare’s Skilled Nursing Benefit. The Department of Justice announced last week that Texas-based Regency Nursing and Rehabilitation Centers agreed to pay $4 million to settle allegations that it submitted claims for reimbursement to Medicare and Medicaid for rehabilitation and skilled nursing services that were not reimbursable because the nursing home residents were not qualified for the services, the services were not medically necessary, or they were not supported by adequate documentation. “Nursing home providers participating in Medicare should be on notice that taxpayers will not absorb the costs of improper or false billings submitted to the government and that the Department of Justice will take action against them for submitting such claims,” said Justice Department official Tony West.

To report skilled nursing fraud or other Medicare fraud, contact Frohsin & Barger.