Citadel skilled Nursing and Plaza Rehab pay $7.85 Million after granddaughter reveals scheme of disenrolling her grandfather and others from Medicare Advantage plan to original Medicare to maximize reimbursement

The Citadel Consulting Group, LLC d/b/a Citadel Care Centers LLC and TCPRNCLLC d/b/a Plaza Rehab and Nursing Center will pay $7.85 Million to settle the False Claims Act case filed by Relator Wendy Morales concerning her grandfather. She observed that the Plaza personnel intentionally disenrolled her grandfather from his Medicare Advantage Plan and forged his signature making unauthorized changes to his healthcare coverage. The following investigation by the Government revealed a pattern of fraudulent switching of other elderly residents enrolled to maximize Medicare payments the Plaza would receive. The Government said that they did so under the direction of Citadel. Ms. Morales will receive $1.5 million which is 19% of the settlement amount under the False Claims Act, a law that allows individuals with information about fraud to file claims on behalf of the Government. In addition, the Plaza and Citadel often did not offer the Plaza residents assistance in re-enrolling them in a Medicare Advantage Plan upon discharge from the P{aza facility. The whistleblower was represented by Peter Katz LLC of New York.

JEFFREY NEWMAN, A FORMER PROSECUTOR IS A WHISTLEBLOWER LAWYER WITH THE FIRM NEWMAN & SHAPIRO. HE CAN BE REACHED AT JNEWMAN@NEWMANSHAPIRO.COM OR AT 617-823-3217.