Nursing home firm pays $48 million to settle Medicare Fraud case for needless therapy

The Ensign Group Inc. which operates a large number of nursing homes has agreed to pay $48 million to resolve allegation that it submitted inflated bills to Medicare for physical, occupational and speech therapy services for Medicare beneficiaries which weren’t medically necessary or never took place.

The case which was originally brought by two company whistleblowers Gloria Patterson and Carol Sanchez was joined by Uncle Sam and related to billing from the period 1999 to 2011. The allegations stated that Ensign incentivized therapists to increase the amount of therapy provided to Medicare beneficiaries that weren’t medically necessary.

The case was brought under the False Claims Act which allows individuals to bring a case on behalf of the government and to collect up to 30% of what the Government collects. The whistleblowers are expected to be rewarded about $4.8 million each for bringing forth the information concerning company fraud.

Jeffrey Newman represents whistleblowers