BUFFALO, N.Y. (WENY) – Elderwood Administrative Services LLC, have agreed to pay $950,000 to resolve allegations regarding false claims submitted to Medicare and Medicaid.
According to the U.S. attorney’s office, between August 2013 and December 2018, Elderwood knowlingly submitted false claims for payment to Medicare. The payments allegedly involved physical therapy, occupational therapy, and speech therapy services that were medically unnecessary.
The U.S. Attorney’s office says the submission of these claims resulted in Elderwood receiving higher than usual payments from Medicaid.
“This settlement reflects the commitment of my office to hold everyone, including healthcare providers, accountable when they seek to defraud the government,” said U.S. Attorney Ross. “My office will continue to ensure that federal taxpayer dollars meant to serve Medicare and Medicaid patients are spent on needed services and we will not allow healthcare providers to become unjustly enriched when they bill for unnecessary services.”
The civil settlement includes the resolution of claims brought under whistleblower provisions of the False Claims Act by Jean Nolan. Under those provisions, a private party can file an action on behalf of the United States and receive a portion of any recovery.
In a statement, Chuck Hayes, Vice President of Marketing and Communications for Elderwood said, “Defending these types of subjective allegations of overutilization in court requires an unsustainable allocation of resources that we believe are better used to enhance resident care.”
The statement also said that the settlement is “not an admission of guilt and the former employee’s complaint remains a set of allegations and not a statement of fact.”
The company, which has locations in Hornell and Waverly, provides post-acute health care services, including skilled nursing and inpatient rehabilitation.