Nursing Home Pays To Settle Fraud Charge

A Spokane nursing home is among six care centers agreeing to pay the government nearly $190,000 to settle Medicare fraud allegations involving a third-party billing firm.

St. Luke’s Extended Care Center of Spokane will pay $49,500 to end the civil case, U.S. Attorney Kate Pflaumer said in Seattle.

The other facilities taking part in the settlement and the amounts they will pay are: Central Convalescent, Yakima, $61,299; Terrace Heights, Moses Lake, $17,500; Regency Care Center, Walla Walla, $60,273; Regency Care Center, Arlington, $3,041; and Regency Care Center, Monroe, $1,232.

The allegations center on a company called Handled With Care that contracted with the nursing homes to submit claims to the federal Medicare program on the homes’ behalf, Pflaumer said.

The claims sought reimbursement for medical supplies the nursing homes had furnished to Medicare beneficiaries, but for which the facilities had neglected to bill.

But a government investigation found that most of the claims sought reimbursement for supplies that were never furnished by the nursing homes, Pflaumer said.

There was no direct evidence the nursing homes were aware of the false billings. But the government contended that by turning over their Medicare provider numbers to Handled With Care and by failing to exercise adequate supervision, the facilities knowingly caused false claims to be submitted for Medicare reimbursement.

Handled With Care’s principals were previously prosecuted by the U.S. Attorney’s Office in San Francisco and sentenced to prison.

St. Luke’s hired Handled With Care in early 1990 to conduct a one-time audit of the care center’s Medicare billings, said St. Luke’s spokeswoman Priscilla Gilkey.

In 1992, a St. Luke’s internal auditor discovered possible discrepancies in some billings associated with Handled With Care’s work, Gilkey said.

St. Luke’s notified federal authorities of the problems and refunded the money from the disputed claims, she said.

The Spokane care center hasn’t used Handled With Care since.

, DataTimes