Atlanta Nursing Home Medicare Fraud
At least 1.3 million vulnerable adults are receiving care in a skilled nursing facility. Some of them have reached the end of their life, while others are trying to recover so they can return home. Medicare Part A will pay for up to 100 days of care in a skilled nursing facility, and most residents are using Medicare or another federal healthcare program to cover the costs.
Unfortunately, fraud is widespread in nursing homes. If you suspect a nursing home is committing fraud, please contact Stacey Evans Law today. Our Atlanta nursing home Medicare fraud lawyer holds nursing homes accountable for illegal practices, and she would like to hear from you to learn more about the suspected fraud.
How to Identify Nursing Home Fraud
Nursing homes are supposed to provide medically necessary care in an efficient manner. Unfortunately, many of them end up committing fraud and submitting false claims to Medicare for reimbursement. Many people receiving care have little idea of whether fraud is being committed, and their loved ones are too worried to scrutinize every bill. Nevertheless, there are some common red flags for fraud:
- The nursing home does not create a care plan, which is required. It is very easy for a patient to receive too much or too little care when the plan is missing.
- You are billed for treatment that you never received. These claims then get submitted to Medicare for reimbursement.
- You receive the same treatments though you are not improving. A nursing home might do this because the treatment is costly, which increases the amount they receive from Medicare.
- The nursing home orders multiple tests which are unnecessary to diagnose a condition.
- You are double billed for treatment or services—a clear case of fraud.
Nursing Home Kickbacks
It is also fraudulent for nursing homes to offer or receive kickbacks. A kickback is anything of value that the nursing home offers someone for referrals, or anything of value they receive for referrals.
- A nursing home cannot pay a hospital to refer critically ill patients to them and then bill Medicare for treating those patients.
- A nursing home cannot accept payment from a hospice care provider for referrals which end up using Medicare.
- A nursing home cannot accept discounted drugs for use with residents at the home who are on Medicare.
- A nursing home cannot discount its services seeking referrals from any entity for a Medicare patient.
Under federal law, these kickbacks also result in false claims to the government.
Blow the Whistle on Nursing Home Medicare Fraud
If you suspect fraud, do not remain silent. What people often imagine is a simple billing error turns out to be part of a large fraudulent scheme involving multiple nursing home employees, doctors, and others.
Stacey Evans Law helps whistleblowers report fraudulent schemes committed against the government and file False Claims Act lawsuits. Whistleblower protections can prevent retaliation or provide a remedy when an employer strikes back. Contact our law firm today to speak with an attorney.
