Three Western New York nursing homes agreed to pay a combined $9 million to resolve allegations of Medicare and Medicaid fraud, U.S. Attorney Michael DiGiacomo announced Monday.
Safire Rehabilitation of Northtowns, Safire Rehabilitation of Southtowns, and Williamsville Suburban were accused of submitting false claims for skilled rehabilitative therapy services from January 2015 until October 2019.
The inflated reimbursement scheme, according to DiGiacomo, included therapy schedules and goals based on insurance policy rather than medical need as well as pressuring therapists to provide care against their recommendations. Residents also were pressured to attend unnecessary or unwanted sessions, and referrals were alleged to have been altered to justify unreasonable and unnecessary therapy.
“Medicare and Medicaid fraud drains taxpayer funds and weakens these vital government programs," DiGiacomo said in a statement. “This settlement reinforces our commitment to safeguarding federal funds and ensuring seniors receive the care they deserve.”
The investigation was a joint effort between DiGiacomo's office and New York Attorney General Letitia James' Medicaid Fraud Control Unit.
"Nursing homes that commit financial fraud are stealing funds meant to provide care for our most vulnerable,” James said in a release. “The Safire homes used fraudulent data to rake in millions of dollars from Medicaid without regard for the needs of the residents they were supposed to be serving. My office has rooted out fraud and resident neglect in nursing homes throughout New York, and we will continue to investigate Medicaid fraud to protect New Yorkers.”