$600,000 recovery for fraud on the Medicare and Medicaid systems by nursing homes

In August 2017, Cory Fein of the Cory Fein Law Firm announced the settlement of a lawsuit he brought in 2014 of a False Claims Act case against a company that manages 12 nursing facilities, and one of the Texas nursing facilities under its management. Mr. Fein brought the case on behalf of his client, a whistleblower who was a former employee of one of the facilities. The former employee refused to accept the routine submission of false claims to the Government and, with the assistance of Mr. Fein, brought this lawsuit resulting in the U.S. Government making a substantial recovery of taxpayer dollars.

The suit, Case No. 4:14-cv-02948, was filed in 2014 by the Cory Fein Law Firm in the U.S. District Court for the Southern District of Texas, Houston Division, and was pursued by the United States Department of Justice on behalf of the United States Department of Health and Human Services’ Office of Inspector General (OIG-HHS) and the Texas Office of the Attorney General and Texas Health and Human Services Commission.

The suit alleged that the defendants knowingly submitted false and fraudulent claims for payment to Medicare, Medicaid and other government-funded programs relating to rehab services. The alleged conduct included rounding up the amount of rehab therapy provided to nursing facility residents, in order to qualify for the highest RUG level (which required at least 720 minutes of therapy per week), which resulted in higher Medicare, TRICARE, and Medicaid reimbursement to the facility.

Attorney Cory Fein of the Cory Fein Law Firm in Houston, Texas represented the whistleblower in the case, in which the Defendants ultimately agreed to reimburse the United States and Texas governments for improperly filed claims related to these billings during 2012 and 2013.