The United States Attorney’s Office for the Eastern District of Missouri has announced a significant civil settlement with Reliant Care Group, along with its management company, rehabilitative services, and affiliated skilled nursing facilities. This settlement addresses claims under the False Claims Act, alleging that Reliant knowingly submitted false claims to Medicare for unnecessary therapy services provided to nursing home residents under their care program.
From January 2008 to April 2014, the allegations state that Reliant provided unnecessary physical, speech, and occupational therapy to residents, many of whom were relatively independent and primarily in skilled nursing facilities due to psychiatric conditions. The core issue was that Reliant purportedly prioritized financial gains over patient needs, providing therapy and then seeking inflated Medicare reimbursements, irrespective of medical necessity. It was further alleged that management at Reliant Care Rehabilitative Services pressured therapists to administer therapy even when they believed it was not medically required for the residents under the Reliant Care Program.
As a consequence of the settlement, Reliant is obligated to repay the United States government $8,368,878. This financial settlement underscores the seriousness of the allegations and the government’s commitment to recovering misused Medicare funds.
In addition to the financial penalty, Reliant has also entered into a comprehensive five-year Corporate Integrity Agreement with the Department of Health and Human Services, Office of Inspector General (HHS-OIG). This agreement mandates that Reliant adhere to stringent reporting obligations. These measures are designed to ensure the Reliant care program operates in full compliance with Federal health care program requirements going forward, safeguarding against future fraudulent activities.
Special Agent in Charge Steven Hanson from HHS-OIG emphasized the significance of this settlement, stating, “Health care fraud is a major and increasingly serious problem… Every dollar that we save or recover allows us to better serve those who really need and deserve our help.” This settlement serves as a clear warning to those who might attempt to exploit the Medicare program for financial gain, undermining the integrity of care programs intended for vulnerable populations.
This civil settlement is part of a broader, ongoing initiative by the Department of Justice and HHS to reclaim funds improperly diverted from the Medicare Trust Account. It is the result of collaborative efforts from the U.S. Attorney’s Office for the Eastern District of Missouri, HHS-OIG, and the Federal Bureau of Investigation, demonstrating a united front against healthcare fraud and a commitment to protecting beneficiaries and the financial stability of essential healthcare programs like Medicare and those offered under the umbrella of a “reliant care program”.
