Skilled Nursing Management Company Settles FCA Claims for Nearly $10M

Tennessee Health Management, Inc., which operates 27 skilled nursing facilities in the Volunteer State, agreed to pay $9.76 million to settle allegations that it violated the False Claims Act.

The agreement was announced by U.S. Attorney Don Cochran for the Middle District of Tennessee.

“Enforcement of the False Claims Act remains a priority of the Department of Justice and this office,” Cochran said a statement.  “When violations are discovered, corporations should seek to immediately cooperate and resolve the allegations and minimize future risks, as THM has done here.”

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The alleged violations involve the submission of false claims for payment related to nursing facility services for beneficiaries of TennCare, Tennessee’s Medicaid program.

The program requires physicians to certify a placement evaluation for each patient entering the nursing home. The settlement resolves allegations that THM submitted pre-admission evaluations with photocopied or pre-signed physician signatures for claims rendered to TennCare beneficiaries at the SNFs in question.

The submissions allegedly occurred between January 1, 2010 through December 31, 2017, according to the U.S. and the state of Tennessee.

As is common with False Claims Act settlements, the Department of Justice noted that the payments do not represent an admission of guilt, and there has been no determinations of liability.

Under the terms of the settlement, Tennessee will receive $4.31 million, while the federal government will receive $5.46 million. In addition, THM will enter a Corporate Integrity Agreement with the U.S. Department of Health and Human Services’ (HHS) Office of Inspector General (OIG).

THM could not be reached for comment as of press time.

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