A record-setting case recently saw a Miami-based care organization involved in a settlement over Medicare fraud. It's a notable case not just for the amount of money involved, but because it represents a new standard for fines levied against a skilled nursing facility, according to the South Florida Business Journal.
The source reports that Plaza Health Network has finally concluded the settlement after the suit was first initiated three years ago. The legal action argued that the nursing center was fraudulently billing Medicare and Medicaid $130 million while also participating in illegal "kickbacks" for facility employees.
Plaza, also known as Hebrew Homes Health Network, will pay $17 million as part of the agreement, making this the largest settlement of its kind to date in this country. In a press release from the United States Department of Justice, Shimon Richmond, Special Agent in Charge of the Department of Health and Human Services' Office of the Inspector General, described the harm the Hebrew Homes action has caused.
As this release describes, the Anti-Kickback Statute forbids deals in which medical parties are unlawfully compensated for referrals.
The Anti-Kickback Statute forbids deals in which medical parties are unlawfully compensated for referrals.
"Hebrew Homes' intricate kickback scheme in this record-setting case threatened the impartiality of physician referrals, the financial integrity of Medicare and the public's trust in the health care system," Richmond said. "Our agency will continue to investigate nursing homes and other health care providers that seek to illegally boost profits at the expense of federal health care programs."
A legal nurse consultant can offer important assessment and advisory services to facilities that need more knowledge about their operations in order to stay compliant with major regulations.