According to a recent Washington Post article, the U.S. Department of Health and Human Services is investigating rampant fraud and abuse in Medicare billing for “high-end services” at nursing homes. The Justice Department said nursing homes have been categorizing patients inappropriately in billing forms in order to receive higher payments from Medicare for “services not rendered, and … worthless services.” This article caught my eye because it’s yet another example of the wrongdoing that nursing homes and their staffs can get up to right in front of patients who are unable to clearly object or tell an outsider. As a Pennsylvania nursing home abuse attorney, I wonder whether nursing homes that try to make higher profits by overbilling Medicare are also more likely to try to generate profits by overmedicating or financially abusing patients.
The article alleges that nursing homes have been categorizing many more of their patients in “ultra-high” Medicare billing categories than can be justified by those patients’ medical records. Medicare has annually paid out up to $542 million more than it should have for services for these patients. The recently enacted health care reform legislation changed the rules to combat this problem, which is considered part of the “waste, fraud and abuse” that both parties oppose. Certain nursing home chains have been singled out as especially egregious offenders, including HCR ManorCare, which operates in cities throughout Pennsylvania.
The article does not specify the kinds of unperformed services for which nursing homes charged Medicare. But with the recent settlements for pharmaceutical company kickbacks to nursing homes for overmedicating patients for profit, as a Philadelphia nursing home negligence lawyer, it seems fair to wonder whether a nursing home that cheats in one way isn’t dishonest in other ways too. I am glad that the Department of Health and Human Services is thoroughly investigating these patterns of fraud and putting nursing homes on notice that increasing profits through fraudulent claims is unacceptable. Hopefully, the increased scrutiny will encourage nursing homes to be more conscientious in all aspects of their work. It is important as As a Philadelphia injury lawyer to stay vigilant with regard to these nursing home practices.
Unfortunately, I have seen many cases in which nursing homes have harmed patients in their desire for greater profits. But the good news is that victims can fight back, with the help of a lawyer at Rosenbaum & Associates. For a free consultation with an experienced nursing home abuse lawyer, please call us at 1-800-7-LEGAL-7 or contact us online.