U. S. Attorney Byung J. “BJay” Pak of the Northern District of Georgia announced Friday that Signature HealthCare has agreed to pay more than $30 million to resolve allegations that it violated the False Claims Act.
The Louisville, Kentucky-based company owns and operates about 125 skilled nursing facilities, including operations in Georgia. Pak said Signature has agreed to resolve allegations that it knowingly submitted false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary and skilled. Pak said those charges are allegations only and that Signature has made no admission of liability.
Signature Healthcare CEO and President Joe Steier said in an email:
“This settlement allows us to move forward in serving our residents and families with quality health care and a commitment to compassion. We worked with the government over the past year to get us here. Resident care remains our first priority, and therapy services are and remain an important part of that care. We are more focused than ever on our mission to serve each resident and family with excellence, and will continue to work hard each and every day to deliver great outcomes for our residents.”
Pak said the government investigated Signature’s policies and practices, including allegations of setting unrealistic financial goals and scheduling therapy to achieve the highest reimbursement level, regardless of the clinical needs of its patients. Pak said the investigation showed Signature providing and billing for unreasonable, unnecessary and unskilled services for Medicare patients.
“Our most vulnerable citizens are put at risk when healthcare providers put their financial interests above their patients’ needs and valuable federal funds are diverted from where they are surely needed,” Pak said. “This settlement demonstrates our commitment to pursuing healthcare providers who provide unnecessary care to advance their bottom line.”
Pak said the settlement resolves not only his investigation but also claims filed in a civil lawsuit by Kristi Emerson and LeeAnn Tuesca, former Signature therapy employees, in federal court in Nashville, Tennessee. The case is captioned United States ex rel. Emerson and Tuesca v. Signature HealthCARE, LLC, et al., Case No. 1:15-cv-00027 (M.D. Tenn.). The lawsuit was filed under the qui tam, or whistleblower, provisions of the False Claims Act, which permit private individuals to sue on behalf of the government for false claims and to share in any recovery. The act also allows the government to intervene and take over the action, as it did in this case. The whistleblowers are to receive a portion of the recovered funds.
“Today’s settlement demonstrates our continuing efforts to protect patients and taxpayer by ensuring that the care provided to beneficiaries of government-funded healthcare programs is dictated by clinical needs, not a provider’s fiscal interests,” said Acting Assistant Attorney General Chad Readler of the Justice Department’s Civil Division in the same news release. “Nursing home facilities provide important services to our elderly, and those facilities must uphold the trust placed in them by billing the government only for reasonable and necessary services.”