Compliance News Roundup: Positive Airway Pressure

1. Signature HealthCARE to Pay More Than $30 Million to Resolve False Claims Act Allegations Related to Rehabilitation Therapy – “Signature HealthCARE, LLC (Signature), a Louisville, Kentucky based company that owns and operates approximately 115 skilled nursing facilities, including 7 in middle Tennessee, has agreed to resolve allegations that it violated the False Claims Act by knowingly submitting false claims to Medicare for rehabilitation therapy services that were not reasonable, necessary and skilled, the Department of Justice announced today. The settlement also resolves allegations that Signature submitted forged pre-admission certifications of patient need for skilled nursing to the state of Tennessee’s Medicaid program. Under the settlement agreements, Signature has agreed to pay more than $30 million. As part of the resolution, the State of Tennessee will receive a portion of the overall settlement.” Get the full scoop >>

2. Allegiance Health Management to Pay More Than $1.7 Million to Resolve False Claims Act Allegations – “The Justice Department announced today that Allegiance Health Management, Inc., (Allegiance), a post-acute healthcare management company based in Shreveport, Louisiana, and four hospitals owned and operated by Allegiance (collectively, the Allegiance Defendants), have agreed to pay more than $1.7 million to resolve False Claims Act allegations that the Allegiance Defendants submitted, and caused other hospitals to submit, claims for reimbursement from Medicare for services that were not medically reasonable or necessary.” Get the full scoop >>

3. Deeper Than the Headlines: Positive Airway Pressure – “The OIG concluded most Medicare claims for replacement Positive Airway Pressure (PAP) device supplies did not comply with Medicare requirements. The report was posted on their website in June 2018. According to their report, previous OIG reviews found that Medicare allows replacement of positive airway pressure (PAP) device supplies more frequently than what is reasonable and necessary and that durable medical equipment (DME) suppliers often do not have the documentation required to support the need for replacement supplies. So, the OIG set about to determine whether Medicare claims that DME suppliers submitted for replacement PAP device supplies complied with Medicare requirements. Let’s dive into it, shall we? Get the full scoop >>