A Michigan-based physician group whose main clientele were nursing home patients must face trial on False Claims allegations after a judge rejected the group’s arguments that its alleged billing discrepancies did not amount to fraud.
US District Judge Staci Yandle last week denied a motion for summary judgment by General Medicine, 17 related companies and owner Thomas Prose, MD. In 2022, the government accused the providers of intentionally scheduling unnecessary visits with skilled nursing patients, duplicating services or upcoding to boost Medicare payments.
Yandle had previously denied a similar motion on different grounds in 2023, allowing the case to proceed to the discovery phase. Attorneys for Prose and General Medicine filed a new motion for summary judgement last summer, claiming that the government and its witnesses “failed to identify a single false or fraudulent claim.”
“The Government’s expert witnesses admitted they were not even asked by the Government to identify any false claims,” the attorneys argued, also calling on the court to exclude the testimony of government statistician Michael Petron because the end result of a submission sample he reviewed was a finding of “overpayments,” not false claims.
Another witness, General Medicine said, testified that patients in skilled nursing facilities are seen, on average, twice a week and as long as the visit is “medically necessary,” the frequency of visits does not alone determine whether a claim should be...
The White House has rejected allegations made by outgoing counterterrorism official Joe Kent, who resigned on March 17 while accusing Donald Trump of launching an unjustified war against Iran. Ken...