Elderly at Johns Creek assisted living homes given unneeded physical therapy in billing scheme, feds say

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In a wide-ranging scheme, SunDance Rehabilitation Corp. bilked U.S. taxpayers out of millions of dollars by billing Medicare for unnecessary physical therapy, a federal whistleblower lawsuit charged. On Friday, the government announced that the parent company of SunDance would pay $5.3 million to resolve the case.

Georgia resident Teresa McAree filed the lawsuit in 2012, accusing SunDance of harassing and intimidating therapists to keep patients longer and to see them more often. McAree, who is a licensed physical therapist, worked for the company at two assisted living facilities in the Johns Creek area and alleged that SunDance employed a “why not” approach in deciding if a patient needed physical therapy.

“SunDance therapists, including McAree, were under constant pressure by management to admit patients in order to build caseload, even if just for normal aging issues that might not rise to the level of medical necessity…or to prescribe a therapy course or frequency that was not merited for a particular patient,” the lawsuit alleged.

Managers routinely requested physical, occupational and speech therapy for almost every patient, she also alleged, because they knew physicians would sign off on the orders without medical need having necessarily been established.

The federal government later joined the case, which was investigated by the U.S. Attorney’s Office in Atlanta, the FBI, the inspector general for the U.S. Department of Health & Human Services and the Defense Criminal Investigative Service. The government alleged that the scheme went on for almost six years and involved not only SunDance Rehabilitation Corp. but also SunDance Rehabilitation Agency and Sun Healthcare Group.

Genesis Healthcare, which had acquired SunDance shortly before McAree’s lawsuit was filed, had denied the allegations. Because of the settlement, the lawsuit was dismissed with no determination of liability.

Under terms of the settlement, Genesis will pay about $5.3 million. The settlement amount was based on Genesis’ ability to pay, according to a news release from the U.S. Attorney’s Office.

No information was available Friday on the amount of damages the government had been alleging.

Genesis also has paid to settle other federal lawsuits alleging unnecessary therapy and substandard nursing care, the Washington Post report. Read the story here: https://www.washingtonpost.com/national/health-science/genesis-healthcare-to-pay-536m-to-settle-us-probes/2017/06/16/136d8088-52d1-11e7-b74e-0d2785d3083d_story.html?utm_term=.4432b32eb31e




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