Haverhill-based skilled nursing facility operator Whittier Health Network, Inc., and its Director of Long Term Care, Leo Curtin, have agreed to pay $2.5 million to resolve allegations concerning inflated Medicare claims.
The agreement announced today concerns rehabilitation therapy that Massachusetts-based Therapy Resources Management (TRM) purportedly provided at Whittier facilities in Massachusetts and New York. The settlement resolves allegations that Whittier and Mr. Curtin failed to take sufficient steps to prevent TRM from engaging in a pattern and practice of fraudulently inflating the reported amounts of therapy provided to Medicare Part A patients in Whittier facilities. Specifically, the facilities submitted bills for therapy that allegedly did not occur as reported, because the therapists were actually conducting initial evaluations when they claimed to be providing therapy. In addition, the therapists reported therapy time using estimates that often were rounded up from the actual minutes of therapy provided, despite Medicare rules specifically prohibiting the reporting of estimated or rounded numbers of minutes.