Date: April 25, 2023
The Acadiana Advocate, and other local Louisiana publications, reported on the $1.7 million settlement of a Medicare fraud suit involving medically unnecessary inpatient rehabilitation services. The whistleblowers who filed the case, Tamra Boyd and Nancy Morrill, will share over 20% of the settlement amount paid by their former employers, Lafayette Physical Rehabilitation Hospital, Acadiana Management Group, LLC, and Dr. Carolyn Smith. The whistleblowers were represented by TELG principal Janel Quinn.
[EXCERPT]
Lafayette rehab hospital, doctor agree to pay $1.7 million settlement for false Medicare claims
A Lafayette rehabilitation facility, its parent company and a Lafayette doctor have agreed to pay a $1.7 million settlement to resolve claims they made false Medicare claims for patients that did not qualify for and did not require inpatient rehabilitation.
Lafayette Physical Rehabilitation Hospital and its management company, Acadiana Management Group LLC, have agreed to pay $1.2 million and Dr. Carolyn Smith has agreed to pay $575,000 to settle the claims, U.S. Attorney for the Western District of Louisiana Brandon Brown said in a statement.
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In connection with the settlement, Smith agreed to be excluded from participation in federal health care programs for 10 years, according to the U.S. Department of Health and Human Service’s Office of the Inspector General.
Smith’s medical license was suspended in November 2016, per the Louisiana State Board of Medical Examiners.
» View full story on the Acadiana Advocate
[OFFICIAL ANNOUNCEMENT]
United States Settles Claims for Improper Inpatient Rehabilitation Admissions for over $1.7 Million
From the U.S. Department of Justice (Apr. 24, 2023)
LAFAYETTE, La. — United States Attorney Brandon B. Brown announced that Lafayette Physical Rehabilitation Hospital and its management company, Acadiana Management Group, LLC have agreed to pay $1.2 million, and Dr. Carolyn Smith agreed to pay $575,000 to resolve allegations that they violated the False Claims Act by submitting claims to Medicare for medically unnecessary inpatient rehabilitation services.
“This settlement demonstrates our commitment to ensuring that those who participate in federal healthcare programs follow the rules,” said U.S. Attorney Brandon B. Brown. “Billing for non-covered rehabilitation hospital stays results in a misuse of federal dollars. The financial viability of our Medicare program must be protected for current and future generations.”
The United States alleged that from January 1, 2010 through December 31, 2016, Dr. Smith admitted certain patients to Lafayette Physical Rehabilitation Hospital for whom inpatient rehabilitation treatment was not medically reasonable or necessary. Dr. Smith repeatedly admitted these patients, often by putting improper pressure on the patients, and falsely certified that the patients met the applicable criteria for inpatient admission. However, the patients did not satisfy the criteria and did not need impatient rehabilitation services.
» View press release on Justice.gov
[ADDITIONAL COVERAGE]
Lafayette rehab hospital paying out $1.2 million settlement for false claim allegations
From Lafayette Daily Advertiser (Apr. 25, 2023)
A Lafayette rehabilitation hospital and its management company agreed to pay more than $1 million to settle allegations they submitted claims to Medicare for medically unnecessary inpatient rehabilitation services, the U.S. Attorney’s Office for the Western District of Louisiana announced.
The Lafayette Physical Rehabilitation Hospital and Acadiana Management Group, LLC are paying out $1.2 million in the settlement, while Dr. Carolyn Smith agreed to pay around $575,000.
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“The Department of Health and Human Services, Office of Inspector General (HHS-OIG) will continue to aggressively investigate health care providers who submit Medicare claims for medically unnecessary services,” HHS-OIG Special Agent in Charge Jason Meadows said in a release. “Inpatient rehabilitation services are expensive, and Medicare dollars should be reserved for patients who need those services – not hospitals and physicians seeking to make easy money through improper billing.”
» View full story on Lafayette Daily Advertiser
Lafayette rehab hospital, management company and physician agree to settlement
From KATC (Apr. 24, 2023)
A Lafayette rehab hospital, it’s management company and a physician have agreed to pay more than $1.7 million to Medicare under the False Claims Act, federal officials say. The settlement stems from a whistle-blower complaint filed by two former employees, who will take home 20 percent of the money.
