Carter Healthcare billed the federal program for unnecessary medical treatment, according to the Department of Justice.
A 91-year-old Florida man with a shoulder injury and dementia wasn’t benefiting from repeated physical therapy sessions, the man’s therapist told his boss.
But Carter Healthcare continued sending a therapist to the man’s home and billing a federal government benefits program even though the man’s wife refused the treatment, according to a complaint filed in federal court.
In another case, Carter Healthcare fired occupational therapist Sharon Mahaffey after she refused to recommend more treatment for a patient whom she considered healed, the complaint states.
Earlier this month, the U.S. Department of Justice announced that Carter Healthcare will pay $7.1 million to resolve allegations that it overbilled for home care therapy paid by Medicare and gave unneeded medical treatment to patients across Florida.
The complaint filed in the U.S. District Court South District of Florida on behalf of Mahaffey and another whistleblower revealed that Carter Healthcare expected employees to ensure patients received a minimum of 18 home physical or occupational therapy sessions — no matter their condition. It then billed Medicare, the federal health insurance program for people 65 and older, for payment.
The treatment quota was standard across the company, the complaint states. The number was determined to be below the level that would trigger additional scrutiny from...
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