$48 Million Settlement for Medicare Fraud

     LOS ANGELES (CN) – The Ensign Group, a Southern California-based nursing home chain, will pay $48 million to settle Medicare fraud charges.
     The Mission Viejo-based chain that operates nursing homes across the Western United States admitted it inflated bills for “therapy services that were medically unnecessary or were never provided to elderly patients at six of its Southern California skilled nursing facilities,” federal prosecutors said Tuesday.
     A federal judge unsealed the lawsuit against the chain late Monday.
     The six Ensign homes named in two federal whistleblower lawsuits are Atlantic Memorial Healthcare Center in Long Beach, Panorama Gardens in Panorama City, Orchard Post Acute Care (commonly called Royal Court) in Whittier, Sea Cliff Healthcare Center in Huntington Beach, Southland in Norwalk, and Victoria Care Center in Ventura, the U.S. Attorney’s Office said in a statement announcing the settlement.
     The statement said: “The lawsuit specifically alleged that Ensign improperly incentivized therapists and others to increase the amount of therapy provided to patients to meet planned targets for Medicare revenue, which were set without regard to patients’ individual therapy needs and could only be achieved by billing at the highest reimbursement levels.
     “The six facilities also allegedly submitted claims for services that were not provided.”
     As is customary with settled federal complaints against wealthy corporations, Ensign Group did not have to admit that it did anything wrong.

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