Physical Therapist Claims Rehabilitation
Facility Engaged in
Medicare Fraud and Unlawful Termination
Submitting false claims for treatments and services that were not needed or not performed and failing to investigate a complaint that such claims are being submitted may result in violations of the False Claims Act
Compliance PerspectiveĀ –Ā Medicare FraudĀ
Policies/Procedures: The Compliance and Ethics Officer with the Administrator and Director of Rehabilitation Services will review policies and procedures regarding submission of properly coded and documented therapy services and treatments.
Training: The Compliance and Ethics Officer with the Director of Rehabilitation Services will ensure that therapists are trained to properly code and document the services/treatments they provide.
Audit: The Compliance and Ethics Officer should personally conduct an audit to determine if the physical therapy services being provided to residents are appropriate and necessary, and if documentation represents services actually provided.
A physical therapist is suing a Pennsylvania rehabilitation facility alleging retaliation and wrongful termination in violation of the Pennsylvania Whistleblower Act. The plaintiff claims he was fired after reporting that a newly hired director of rehabilitation and a physical therapy assistant failed to properly document the treatments performed and submitted requests for reimbursement to Medicare for treatments and services not performed.
After the plaintiff reported what he believed to be false to his superiors, the facility failed to take any corrective action; instead, the defendant attempted to justify the director of rehabilitationās conduct.
The plaintiff also alleges that he was directed by another superior to perform further treatment on residents and to bill Medicare for services that were not necessary. When he refused to comply, he said that he was abruptly terminated. He claims his termination was in retaliation for his reporting, in good faith, complaints of wrongdoing and for opposing and refusing to participate in illegal activities.
A jury trial is requested along with a judgment for compensatory damages, pecuniary losses, pre-and post-judgment interest, and other relief that might be considered appropriate.
