Ohio based Foundations Health Solutions Inc. (FHS), Olympia Therapy Inc. (Olympia), and Tridia Hospice Care Inc. (Tridia), and their executives, Brian Colleran (Colleran) and Daniel Parker (Parker), have agreed to pay approximately $19.5 million to resolve allegations pertaining to the submission of false claims for medically unnecessary rehabilitation therapy and hospice services to Medicare, the Department of Justice announced today.
Acting Assistant Attorney General Chad A. Readler of the Justice Department’s Civil Division, said “Clinical decisions should be based on patient needs rather than corporate profits. This settlement reflects the Department’s continuing commitment to safeguarding patients and the Medicare system.”
The settlement resolves allegations of false Medicare claims from these companies for “medically unnecessary rehabilitation therapy services at 18 skilled nursing facilities. The government contended that the therapy services were provided at excessive levels to increase Medicare reimbursement for those services.”
The settlement also settles claims that Tridia submitted false claims to Medicare for hospice services regarding patients who were ineligible for the Medicare hospice. In short, Tridia failed to conduct proper certifications or medical examinations. Moreover, the settlement resolves allegations that Colleran and Parker solicited and received kickbacks from referring patients to skilled nursing facilities.
U.S. Attorney Benjamin C. Glassman for the Southern District of Ohio said,
This is one of the largest nursing home operations in Ohio. It is unacceptable for an entity entrusted to care for our most vulnerable and elderly citizens to make decisions based on profit, not quality of care. Subjecting the elderly to inappropriate levels of therapy can be physically harmful, and failing to properly certify and re-certify hospice patients can have a devastating impact on the patients and their families.
The settlement is the result of a coordinated effort by the Civil Division’s Commercial Litigation Branch and the U.S. Attorney’s Office for the Southern District of Ohio, with assistance from HHS-OIG, the HHS Office of Counsel to the Inspector General, and the Ohio Medicaid Fraud Control Unit.
Attorney General Sessions was appointed to his position by President Trump. He was confirmed on February 8, 2017, with a 52–47 vote in the Senate, and was sworn in on February 9th. Since that time, he’s aggressively prosecuted Medicare and Medicaid fraud.