Diversicare Healthcare Services LLC and two certified occupational therapy assistants paid $1.38 million after submitting Medicare claims for occupational therapy services that were never provided to beneficiaries at their Alabama facilities.

Diversicare Healthcare Services (Alabama) — OT Services Never Provided, $1.38M Settlement (2023)

Outcome: Diversicare Healthcare Services LLC, a major long-term care operator, and two certified occupational therapy assistants paid $1,377,696 to resolve False Claims Act allegations that they billed Medicare for occupational therapy services never delivered to nursing home residents.

Diversicare Healthcare Services LLC operates a national network of skilled nursing and long-term care facilities. At its Alabama facilities, two certified occupational therapy assistants (COTAs) submitted Medicare claims for occupational therapy services they did not actually provide to residents. Diversicare entities benefited from these false billings as the SNF operator receiving Medicare reimbursement.

Billing for therapy services not rendered is one of the most common forms of SNF Medicare fraud. It typically involves documentation showing scheduled or planned therapy that was never completed, or phantom billing where therapy records are created without any corresponding treatment. The settlement of $1,377,696 was announced July 12, 2023 by U.S. Attorney Sandra J. Stewart for the Middle District of Alabama.

Primary Source: OIG Enforcement Record