Kindred Healthcare, the largest U.S. nursing home therapy provider, has agreed to pay $125 million to settle federal charges that it provided unreasonable and unnecessary services to patients to inflate Medicare billings.

In announcing the settlement, the Department of Justice said Tuesday that Kindred’s RehabCare unit had a policy of setting unrealistic financial goals and scheduling therapy to achieve the highest reimbursement level regardless of the clinical needs of its patients.

“Medicare beneficiaries are entitled to receive care that is dictated by their clinical needs rather than the fiscal interests of healthcare providers,” Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the DoJ’s civil division, said in a news release. “All providers, whether contractors or direct billers of taxpayer-funded federal healthcare programs, will be held accountable when their actions cause false claims for unnecessary services.”

RehabCare, which Kindred acquired in 2011, contracted with more than 1,000 nursing homes in 44 states to provide rehabilitation therapy to their patients. Four nursing homes that hired RehabCare agreed to pay the federal government about $8 million for their role in the alleged overbilling scheme.

The case was initially filed under the whistleblower provisions of the False Claims Act by Janet Halpin, a physical therapist and former rehabilitation manager for RehabCare, and Shawn Fahey, an occupational therapist who worked for RehabCare.

Among other allegations, the Justice Department said Kindred presumptively placed patients in the highest therapy reimbursement level, rather than relying on individualized evaluations to determine the level of care most suitable for each patient’s clinical needs.

The company also allegedly scheduled therapy even after the patients’ treating therapists had recommended that they be discharged from therapy and reported that skilled therapy had been provided when in fact the patients were asleep at the time.

RehabCare “engaged in a systematic and broad-ranging scheme to increase profits by delivering, or purporting to deliver, therapy in a manner that was focused on increasing Medicare reimbursement rather than on the clinical needs of patients,” said Carmen Ortiz, U.S. Attorney for Massachusetts.

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5 responses to “Kindred Healthcare to Pay $125M Over Medicare Fraud”

  1. This company is evil; thank Goodness they were caught and stopped from doing these illegal activities. Kudos to the whistleblowers.

    • they were caught but with all their political pull , stopping them is close to impossible. forcing patients on ventilators they may not need, at least in Brevard county, Fl. after forcing my husband on a ventilator after i went home one evening from visiting him at Holmes Regionol in Melbourne, he was forced on a ventilator he never needed by Dr Jerry Pinto even as he protested very loudly(no breathing problem here).No one had a reason and a nurse who came in the morning after the incident said pulled me aside and said she needed to tell me that she was there when it happened and my husband had not repeatedly and very loudly( Her Words , “ALL HELL BROKE LOOSE” as he was forced on the vent against his will. The reason? to send him over to Kindred for “rehab” where his GOOD FRIEND” DR, Anthony Santilli would have him back on his feet and home in just a few days. DR. Pinto misreprented Kindred as a Rehab and an LTAC hospital which my husband had no need for. He also would leave out the fact that Dr.Santilli was the medical director at Kindred whose job was to refused to allow patients or their families second opinions,refused their discharge or transfer,kept them prisoners by chemical restraint, and had family members who reported the abuse that would follow blocked from the hospital. Threatened with jail if they tried to visit their loved one That was very easy here in Melbourne as the police advised us they were not allowed to get involved -their hands were tied when it came to Kindred. No help was available congressman BIll posey (R) was notified by a south Fl, congressman- he would never help ignoring our pleas for help.Senator Bill Nelson (Dem. FL) would not help – pretended not to have the correct paper work. As it turned out Nelson had the second highest allowed campaign donation in the 2010 election from Kindred- The highest donation went to Senator Mitch Mcconnell (R senator from Ky. who is now the senate majority leader.)Not surprisingly, KY. is where Kindred Corp. Headquarters are located and is now k as the largest known as ” the largest diversified health care corp in American”. My husbands ordeal was 5 yrs. ago. NO one has ever done an investigation, Kindred continues to thrive and as one prominent dr .recently told us,” I would never send a patient to Kindred-patients die there. They and their families are badgered to sign a DNR and once it is signed, they die very shortly after.

  2. I have seen so much illegal kickbacks at my local Kindred Hospital in Green Cove Springs, Florida that it makes me puke. The “only” Pulmonary doctor sees 40 to 50 patients in the hospital every single day and charges the highest billing codes to Medicare every single day for every single patient and drives fancy Lamborghini’s, Ferraris, Porsches, etc. and documents providing “one hour of critical care” on most patients even though he only spends a few minutes. Yet, he hasn’t been caught. The Infectious Diseases doctor sees 40 to 50 patients every single day and charges for critical care (highest paying billing codes) and she drives a fancy Porsche Carrera and she hasn’t been caught yet. All of these doctors give kickbacks to the hospitalists that refer patients to them – these kickbacks are disguised as exorbitant “billing charges” and “management charges” and “office space rent” so that these evil doers wouldn’t get caught. None of these people have been caught yet so their defrauding of Medicare goes unchecked. Overall, nationally Kindred has over $7 Billion in revenue. Any idea how they generate such a high revenue? I sure do. Somebody needs to blow the whistle on these crooked people at my local Kindred Hospital in Green Cove Springs, Florida.

  3. doctor, thank you for your input and your honesty. I am well aware of the fraud that is allowed to continue at Kindred as I have followed it for the last 4 yrs. after my husband was held against his will at kindred in Melbourne after he was forced on a ventilator by a dr. at Holmes Regional in Melbourne.. Kindred held him against his will even though he proved he could breathe just fine-never needed the vent, they kept drugging him and forcing him back on the vent. We finally got an administrative move due to a concerned Kindred employee like yourself. That saved his life. In Fl., no one will investigate very likely due to a dishonest secretary of AHCA who covers it up. What happened to my husband was unbelievable but we continue to fight for justice. We have the evidence but no one will look at it-Kindred is immune from prosecution in FL. Your letter gives us more insight. We knew the Dr. at Holmes was involved as well as the Kindred Ceo and the primary care Dr. at Kindred who . Yes, the kickbacks are the reason but they were not illegal as they all involved refferels from ACO doctors to Kindred -an ACO hospital. under the ACA act, ACO’s and their members are exempt from prosecution for kickbacks if they are done from one member of an ACO to another ACO participant. Self-referrals are also allowed. Money-hungry physicians and Kindred are getting very wealthy and medicare patients are being endangered as the public is left in the dark. We are in danger in Brevard county as we have a very large group of Doctors involved in the Premier ACO -MPAC which is headed by Dr. Gopal Gododia, a doctor who wrote a fictious report making it look like my husband was desperately ill and needed to be put on a vent and sent to Kindred. Dr. Jerry Pinto, a pulmonoligist at Holmes who collected the highest amt. allowed from medicare collected that amt. daily for “treating” my husband while he was at Holmes(approx 3 wks.) is also connected to MPAC as is Dr. Naveen Kumar ,the physician whose care Dr. Pinto referred him to at Kindred and who kept giving my husband narcotics and opioids to keep him chemically restrained at kindred. Other patients accuse him of the same. It paid well as,Dr. Kumar boasted on his website that in 2012(the year he kept my husband imprisoned) he made 1.1 million dollars from medicare just for his daily hosp. visits to his hospitalized medicare patients. Then there was the Kindred Medical Director-a pulmonoligist who billed Medicare the daily amount allowed for that “critical care” hr. for his daily rounds of all the medicare patients he was holding on ventilators and not releasing back to an acute care hospital for the treatment they needed as, under his and Kindred’s care, their health declined drastically, developing kidney failure, UTI’s,MRSA, worsening lung failure, and multiple cases of pneumonia.That dr. Dr. Anthony M. Santilli, at last check , no longer has a license in Florida. I am not a physician but I did manage to get the pertinent info , names and records that totally support this story. Most importantly, I did manage to get my husband ‘s release from Kindred and he has been home for almost 4 yrs. now, still no breathing problems whatsoever . We feel we owe it to other medicare recipients to stop this deadly fraud at Kindred . With people like yourselve, hopefully someday we can.

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