Care provider to pay $14.9M over false claims involving assisted living communities

Care provider to pay $14.9M over false claims involving assisted living communities
McKnight's Senior Living; Kimberly Bonvissuto; 6/10/24
A chronic disease management provider will have to shell out $14.9 million over allegations related to false claims involving assisted living communities, memory care communities and group homes. Bluestone Physician Services of Florida LLC, Bluestone Physician Services PA of Minnesota and Bluestone National LLC of Wisconsin agreed to a $14.9 million settlement with the Justice Department. The federal government alleged that Bluestone knowingly submitted false claims to Medicare, Medicaid and TRICARE — the healthcare program for active duty service members and their families — for certain evaluation and management codes for services related to chronic care management of assisted living residents. The settlement agreement resolves allegations that Bluestone submitted “inflated” claims between Jan. 1, 2015, and Dec. 31, 2019, that did not support the level of service provided. The federal government will receive $13.8 million from the settlement, with more than $1 million going to the states of Florida and Minnesota.