For-Profit Nursing Homes Commit Twice as Much Medicare Fraud When Compared to Non-Profits

Federal health care inspectors reported recently that the U.S. nursing home industry overbills Medicare $1.5 billion a year for treatments patients either do not need or never received. The report did not disclose the different practices in the private and non-private sectors.  However, thirty per cent of claims sampled from for-profit homes were fraudulent, compared to just 12 percent from not-for-profit facilities, according to data Bloomberg News and Information obtained from the inspector general’s office of the U.S. Department of Health and Human Services.

The figures illustrate that the rise of for-profit providers is fueling waste, fraud and patient harm. In the past four years, federal prosecutors brought 120 civil and criminal cases against nursing homes and related individuals. That is up 60 percent from previous figures. Many of these lawsuit were clearly for reasons that put profits above patient care and safety.

These for-profit facilities have been sued for forcing weak and severely ill patients to partake in physical therapy, reducing staff to unsafe levels to save money, inflating costs of treatments ("up-coding"), and many other profit-driven care issues. For more, read the story.

Robert W. Carter, Jr. is a Virginia attorney whose law practice is dedicated to protecting the rights of the victims of nursing home and assisted living neglect and abuse in Richmond, Roanoke, Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia

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