A settlement reached to resolve False Claims Act Allegations against North American Health Care Inc, its chairman of the board, John Sorenson, and its senior vice president of Reimbursement Analysis, Margaret Gelvezon.
The allegations arose from a lawsuit claiming North American Health Care Inc; Mr. Sorensen and Ms. Gelvezon violated the False Claims Act by causing the submission of false claims to government health care programs for medically unnecessary rehabilitation therapy services provided to residents at North American Health Care’s skilled nursing facilities.
North American Health Care has agreed to pay $28.5 million, Mr. Sorensen has agreed to pay $1 million and Ms. Gelvezon has agreed to pay $500,000.
According to the Justice Department, North American Health Care caused false claims to be submitted to Medicare and TRICARE, and Ms. Gelvezon, in her capacity as an officer of North American Health Care, contributed to this conduct by creating the improper billing scheme and Mr. Sorensen, in his capacity as chairman of the board of North American Health Care, reinforced this scheme at the North American Health Care facilities.
Allegedly, this conduct occurred during the period from January 21, 2005, to October 31, 2009, for all of the North American Health Care skilled nursing facilities and continued during the period of November 1, 2009, to December 3, 2011, for three of the skilled nursing facilities in the Northern District of California area.
“Today’s settlement should send a message to others who may be engaging in these schemes that we will pursue justice for our beneficiaries and the programs.” stated Department of Health and Human Services-Office of the Inspector General Special Agent in Charge Steven Ryan.
North American Health Care has also entered into a five-year Corporate Integrity Agreement with the department of Health and Human Services-Office of the Inspector General as part of the settlement agreement.
