Encompass Health Corporation, the largest operator of inpatient rehabilitation facilities (IRFs) in the United States, agreed to pay $48 million to settle three lawsuits filed against it.
According to the U.S. Department of Justice (DOJ), Encompass Health violated the False Claims Act. The company allegedly provided inaccurate information to Medicare to maintain the status of its facilities as IRFs and to earn a higher rate of reimbursement.
In addition, the DOJ found that some of the admissions of its IRFs were not medically necessary. The IRFs allegedly falsely diagnosed patients with what they referred to as “disuse myopathy” when there was no clinical evidence for this diagnosis. The IRFs allegedly admitted patients who were not eligible for admission because they were too sick or disabled to participate in or benefit from intensive inpatient therapy.
The settlement was the result of a comprehensive and lengthy investigation into the nationwide scheme to defraud the Medicare and Medicaid.
