In a case that spotlights the misuse of Medicare funds, a Rockford, Illinois skilled therapy provider alongside its current and former owners have agreed to fork over $1.5 million dollars in a federal healthcare fraud settlement. The company, BRYNWOOD MYOFASCIAL THERAPY LLC, was accused of billing Medicare for nonexistent therapy services and using unqualified staff.
The U.S. Attorney's Office for the Northern District of Illinois revealed that the firm and its owners engaged in fraudulent behaviors which included billing for services during times when the provider was supposed to be out of the country, and substituting massage therapists to deliver services that were meant to be provided by properly licensed practitioners. According to a statement released by the Justice Department, there were also claims made for services without appropriate supervision and the utilization of incorrect billing codes strategically to circumvent service caps.
The lawsuit that brought these allegations to light was originally filed by a whistleblower under the False Claims Act, which empowers private citizens to sue on behalf of the United States when they believe someone has submitted false claims for government funds. The whistleblower stands to gain a share of any recovered funds. In this case, the federal government decided to intervene before the settlements and consent judgments were reached.
Per the resolution, BRYNWOOD MYOFASCIAL THERAPY and its current owner MALGORZATA ZASADNY agreed to collectively pay $953,959, while the former owner, MARLA MONGE, settled to pay $615,345. It is important to understand that these are civil settlements which imply no determination of liability. This was clearly emphasized by the Justice Department as it aims to remind the public that these are mere allegations.
Announcements of the settlement were made by officials including Morris Pasqual, the Acting United States Attorney for the Northern District of Illinois, and representatives of the Department of Health and Human Services, Office of Inspector General, and the FBI. Assistant U.S. Attorney Valerie R. Raedy represented the government in the courtroom. This significant financial settlement underscores the continuing fight against healthcare fraud, ensuring that Medicare funds are preserved for those in genuine need.
