Strauss Ventures LLC, doing business as The Grand Health Care System, and 12 affiliated skilled nursing facilities (collectively, the Grand) have agreed to resolve allegations that they violated the False Claims Act by knowingly billing federal healthcare programs for therapy services that were unreasonable, unnecessary, unskilled or that simply did not occur as billed. The settlement resolves allegations that, from as early as Jan. 1, 2014, to Sept. 30, 2019, the Grand knowingly submitted false claims for rehabilitation therapy for residents at 12 facilities Strauss Ventures owned and operated. During this period, Medicare Part A (Medicare’s hospital insurance, which also pays for care in a skilled nursing facility in some circumstances) and TRICARE (the federal healthcare program for the Department of Defense) paid for such services at rates that varied based on the number of minutes of skilled rehabilitation therapy provided. The Grand allegedly submitted bills where the reimbursement claimed was based on providing more therapy than was reasonable and necessary, or in some cases where the therapists did not provide the amount of therapy reported.
