Medicare Compliance & Reimbursement

Physical therapy clinics come under fire for Medicare and Medicaid fraud.

Physical therapy providers should only contract with reputable consultants when submitting enrollment applications and claims to Medicare and Medicaid - or they could end up at the center of a fraud investigation.

Jonathan Jackson, the former owner of Houston-area physical therapy clinic Park Plaza Physical Medicine, Inc., will serve 70 months in federal prison for allegedly defrauding Medicare and Medicaid of millions of dollars, Texas U.S. Attorney Chuck Rosenberg announced on July 26.
 
Result: A judge also ordered Jackson to pay restitution to Medicare and Medicaid for purportedly submitting fraudulent claims to both programs from March 1998 through May 1999. During this time, Jackson allegedly billed the programs for physical therapy services provided to patients in their homes by unqualified and unlicensed individuals, Rosenberg says.

Jackson was also involved with another physical therapy clinic, Quality Medi-Care Clinic, beginning in 1995, Rosenberg alleges.

Jackson purportedly assisted Medi-Care's owners in submitting fraudulent Medicare and Medicaid claims for physical therapy services that licensed therapists never provided or supervised. In 1997, Jackson also allegedly received referral fees from the owners to recruit patients to the clinic.

Read it online: To read the press release, go to http://www.usdoj.gov/usao/txs/releases/July2005/050726-Jackson.htm.