Fraud and Abuse in healthcare remains a hot issue, as evidenced by recent HEAT announcements. Following three qui tam (whistleblower) actions being filed, the Department of Justice announced it would intervene in the consolidated lawsuits. At issue was whether HCR Manorcare exerted pressure on SNF administrators and rehabilitation therapists to provide medically unnecessary and unreasonable services by administering additional treatments to qualify for the highest Medicare payments. Allegations also claimed HCR Manorcare kept patients in its facilities even though they were medically ready for discharge.
With healthcare fraud a top priority for the FBI, healthcare providers need to be aware of the potential for fraud and abuse. These latest allegations against HCR Manorcare are a reminder that healthcare providers need to ensure their services are reasonable and medically necessary.
Here’s a link to the DOJ announcement concerning Manorcare: http://www.justice.gov/opa/pr/government-sues-skilled-nursing-chain-hcr-manorcare-allegedly-providing-medically-unnecessary.
By Denise Bloch
