The Department of Justice issued a press release explaining the lawsuit against Paragon Management and 11 nursing homes they manage. The lawsuit alleges the Defendants committed Medicare Fraud. DOJ contends the nursing homes inflated Medicare reimbursements by giving unsafe and unnecessary therapy. The lawsuit seeks damages and civil penalties under the False Claims Act for fraudulently billing Medicare for unreasonable and unnecessary services provided to patients at skilled nursing facilities located in New York.
Defendants systematically kept patients at the Facilities longer than necessary to maximize billing and profits. The Facilities systematically assessed patients on higher levels of rehabilitation therapy to bill Medicare at the highest rate. Managers instructed and pressured staff to engage in these fraudulent practices. In addition, the Facilities made or used false statements and records submitted to Medicare for payment for rehabilitation therapy that was unreasonable, unnecessary, or unskilled.
HHS-OIG Special Agent in Charge Scott J. Lampert said:
“The Medicare program is designed to protect both beneficiaries and taxpayers. When medical providers bill for unnecessary or improper services, patient care is put at risk and the financial integrity of our federal health care system is compromised. ”