Trakhter, who was employed to provide skilled physical therapy services to the nursing home’s residents, filed suit as a qui tam whistleblower on behalf of the United States under the False Claims Act. The lawsuit describes a fraudulent billing scheme that entailed medically inappropriate overtreatment and mistreatment of patients, all for the sake of a higher Medicare reimbursement rate. The abuse described in the complaint targeted elderly, infirm patients who also suffered from cognitive deficits. They could not defend themselves from their “caregivers” and were unlikely to complain. Cheating Medicare is bad, but this was stomach-turning.
In one of the fifteen situations described, a patient with multiple severe back problems was assigned 75 minutes of therapy. He was overworked and attempted to decline treatment but was required to continue. Shortly after the therapy session, he was diagnosed with a compression fracture.
Another patient presented with a weak heart, mood disorder, kidney failure and low endurance. He was overworked, exhausted and futilely tried to refuse treatment. He argued with the two therapists administering the “therapy,” went into cardiac arrest and died.
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Under the terms of the settlement, Olympia, Provider and their executives agreed to reimburse Medicare $19.5 million and pay $2.9 million to Trakhter. In addition, the parties agreed to enter into a five-year Corporate Integrity Agreement designed to increase accountability and transparency in order to avoid and promptly detect fraud and abuse in the future.