Traditions Health has agreed to pay $34 million to resolve its civil liability under the False Claims Act for submitting medically unnecessary home health claims to Medicare and providing financial benefits to physicians in exchange for referrals, according to a Jan. 22 news release from the Justice Department.
What happened?
- The settlement resolves allegations that from 2021 to 2024, Traditions submitted claims to Medicare from its McAlester, Okla., location for services that were not medically necessary.
- It also resolves claims that from 2019 to 2024, the company paid remuneration to physician-medical directors in Oklahoma and Texas who referred Medicare beneficiaries to Traditions, potentially violating the Anti-Kickback Statute and Stark law.
- Federal law prohibits payments by Medicare for claims resulting from arrangements that violate these laws. Traditions voluntarily disclosed the conduct to the government and received cooperation credit for its internal investigation, disclosures, and remedial measures.
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