Medicare Compliance & Reimbursement

When a compensation package is too good to be true. A Missouri rehab operator capped off a long, hard lesson in Medicare compliance July 28, paying $580,000 to resolve False Claims Act charges. According to U.S. Attorney Raymond Gruender, Edward Fann, his company Bistate Rehab Inc., and Long Term Care Providers Inc. will pay the sum to cap off a whistleblower suit. But the settlement is only the latest chapter in a long enforcement saga. Fann had earlier pleaded guilty to improperly billing Medicare for occupational therapy and physical therapy, billing for excessive compensation, and failing to report two companies as related businesses. He was sentenced to a year in prison. The feds maintained that Fann and his business associate Gary Sanazaro (now deceased), who owned South County Rehabilitation Inc., paid themselves excessive salaries on Medicare's tab by concealing relationships between their companies. The case also involved telling Medicare that services were performed by certified occupational therapists - when in fact the therapists were not certified. South County got slapped with a $2.8 million judgment back in April. Lesson Learned: Make sure you diligently report all related parties with whom you conduct business to Medicare - or face steep consequences.