BUFFALO, N.Y. (WKBW) — The U.S. Attorney's Office announced that Safire Rehabilitation of Northtowns, LLC, Safire Rehabilitation of Southtowns, LLC, and Williamsville Suburban, LLC, have agreed to pay $9 million to resolve fraudulent Medicare and Medicaid billing allegations.

According to investigators, between January 2015 and approximately October 2019, Safire allegedly submitted false claims to the Medicare and Medicaid programs for skilled rehabilitative therapy services that it "knew were not reasonable or necessary, supported by the documentation in medical records, documented as provided, or provided at all."

The U.S. Attorney's Office said Safire allegedly fraudulently inflated reimbursements from the Medicare and Medicaid programs by:

• Scheduling skilled rehabilitative therapy and setting skilled rehabilitative therapy goals for residents based on the reimbursement policies of the residents’ insurer, rather than medical need, such that Medicare and Medicaid beneficiaries were scheduled for more skilled rehabilitative therapy than was necessary
• Pressuring treating therapists to provide therapy even when treating therapists recommended against therapy
• Pressuring residents to attend therapy sessions even after the residents repeatedly refused to participate
• Manufacturing and/or altered therapy referrals and medical records to justify unreasonable and unnecessary therapy

“Medicare and Medicaid fraud drains taxpayer funds and weakens these vital government programs....

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