SACRAMENTO, Calif. — Skilled nursing facility operator Plum Health care Group LLC and its entity Azalea Holdings LLC, dba McKinley Park Treatment Heart have agreed to pay far more than $451,439 to solve allegations that they violated the Bogus Promises Act, Performing U.S. Attorney Phillip A. Talbert announced currently.
Exclusively, Plum Health care Team agreed to resolve allegations that an worker at its McKinley Park Treatment Center knowingly designed billing records for services that were not in fact provided. In accordance to the settlement agreement, Plum Healthcare Group then made use of these bogus documents to monthly bill Medicare, top it to acquire Medicare reimbursements that were increased than warranted. The government also alleges that the management of Plum Healthcare Team realized of the extent of these phony billings to Medicare, did not perform an suitable investigation into this perform, and then failed to post a refund to Medicare for the total quantity administration understood experienced been overbilled or in any other case disclose its fake billings to the govt.
“Medicare individuals who are unsuccessful to voluntarily disclose fraud risk considerable consequences,” said Performing U.S. Legal professional Talbert. “As this settlement can make distinct, knowingly retaining Medicare funds acquired by fraud is alone a violation of the legislation, and this business office is committed to pursuing enforcement actions to treatment this conduct.”
“It’s unacceptable to stick taxpayers with a bill for health care services that have been under no circumstances provided and for overall health care executives to glimpse the other way when these wrong statements had been submitted to Medicare,” stated Distinctive Agent in Demand Steven J. Ryan of the U.S. Well being and Human Companies, Business of the Inspector Normal. “Working closely with our law enforcement companions, we will proceed to secure the integrity of Federal wellness treatment programs and investigate wrong billing allegations.”
“The FBI is fully commited to functioning with our associates to determine and examine fraud, in particular when it defrauds taxpayer-funded plans,” mentioned Distinctive Agent in Charge Sean Ragan of the FBI Sacramento Subject Place of work. “This settlement serves as a warning to Medicare members to diligently audit and examine documents and billing to ensure their organization operations are not in violation of federal legislation.”
The settlement with Plum Healthcare Team resolves allegations initially brought in a lawsuit submitted by a previous staff beneath the whistleblower provisions of the Untrue Claims Act. The act permits private events to sue on behalf of the authorities for false statements for governing administration money and to obtain a share of any recovery. The whistleblower will receive in excess of $90,000 as her share of the restoration from Plum Healthcare Team. The whistleblower’s claims for retaliation and attorneys’ fees are not resolved by this settlement.
This scenario was the outcome of an investigation by the HHS Business office of the Inspector Normal, the Federal Bureau of Investigation, along with the U.S. Attorney’s Office for the Eastern District of California. Assistant U.S. Legal professional Steven Tennyson taken care of the subject for the United States. The statements settled by this agreement are allegations only, and there has been no perseverance of liability.