SAN FRANCISCO (Legal
Newsline) - The U.S. Department of Justice has announced that North American Health
Care Inc. (NAHC), along with John Sorenson, chairman of the board, and
Margaret Gelvezon, senior vice president of reimbursement analysis, will
pay a total of $30 million after allegations of violating the False Claims Act.
According to the DOJ,
the defendants violated the act by causing the submission of false claims to
government health care programs for unnecessary services. The private for-profit company provides inpatient rehabilitation services.
“Medicare patients and those
insured by TRICARE are entitled to receive care necessary for their clinical
needs and not the financial needs of their health providers,” said principal deputy
assistant attorney general Benjamin C. Mizer, head of the Justice Department’s
Civil Division. “Health care providers
will be held accountable if they bill for unnecessary services or
NAHC will pay $28.5 million,
while Sorenson will pay $1 million and Gelvezon $500,000.
“This office is committed to
safeguarding the federal health care programs and the patients who are enrolled
in them,” said U.S. attorney Brian J. Stretch for the Northern District of
California. “Skilled nursing facilities
such as NAHC treat some of the most vulnerable patients in the health care
system. These facilities, and the
individuals who run them, will be held accountable when they provide treatment
based on financial motivations instead of the patients’ needs.”