Facts

Interface Rehab Inc. is a privately held California rehabilitation therapy corporation providing physical, occupational, and speech therapy in a variety of medical settings throughout the State of California. Interface contracted with Longwood Management Corporation to provide rehabilitation therapy services at a number of skilled nursing facilities. Relator Keith Pennetti brought a qui tam action alleging that Interface violated the False Claims Act when it knowingly submitted or caused the submission of false claims for medically unnecessary rehabilitation therapy services provided to Medicare Part A patients at skilled nursing facilities operated by Longwood.

PLAINTIFFS' CONTENTIONS: Plaintiffs contended defendants submitted or caused to be submitted claims for payment to the Medicare Program, Title XVII of the Social Security Act, and the TRICARE Program. Plaintiffs contended that defendants knowingly submitted or caused the submission of false and fraudulent claims to Medicare and TRICARE for medically unreasonable and unnecessary Ultra High Resource Utilization Group levels of rehabilitation therapy provided to Medicare Part A and TRICARE beneficiaries are several facilities. Plaintiffs contended that defendants knew or should have known it was submitting false claims by pressuring therapists to increase the amount of therapy provided to patients in order to meet pre-planned targets for Medicare revenue.

DEFENDANTS' CONTENTIONS: Defendants denied all of the contentions.

Result

The case settled for $2 million.