TC Physical Therapy and Home Health Practices Resolve Civil Liability for Alleged Healthcare Fraud

Great Lakes Therapy Housecalls, P.C., Great Lakes Home Healthcare Specialists, LLC, and their owner, James A. Harvey, have agreed to pay $450,000 to resolve allegations that they violated the False Claims Act by turning in false claims for reimbursement to the Medicare Program, according to the United State Department of Justice.

The settlement resolves allegations from a complaint filed earlier this year by the United States in the U.S. District for the Western District of Michigan.

According to the Department of Justice, the U.S. brought the case titled United States v. Harvey, et al., No. 1:21-cv-442, under the False Claims Act. This authorizes the government to collect up to triple the amount of damages caused by defendants Great Lakes Therapy Housecalls, P.C., Great Lakes Home Healthcare Specialists, LLC, and their owner, James A. Harvey, as well as civil penalties for each violation.

The department states that in the complaint, the U.S. alleged that Great Lakes Therapy Housecalls, P.C., Great Lakes Home Healthcare Specialists, LLC, and their owner, James A. Harvey, submitted hundreds of false claims to the government by knowingly billing Medicare for additional units of physical and occupational therapy services that they never provided.

Additionally, they say the U.S. also alleged that the defendants submitted claims for physical therapy services under the name of an employee while she was on maternity leave, knowingly hired an unqualified individual as a medical social worker and billed Medicare for episodes of care provided to homebound Medicare beneficiaries that included their services, and altered the dates of physician signatures on certifications of beneficiary eligibility for home health services.

The U.S. Department of Justice states that in Sept., the U.S. also reached a civil settlement with Daniel R. McGoran, the former office manager at Great Lakes Therapy Housecalls, for “his role in the fraud scheme involving billing additional units of physical and occupational therapy.” The department says McGoran agreed to pay the United States $75,071.

“Lying to the government when seeking Medicare reimbursement and falsifying patient records cheats taxpayers everywhere who support the Medicare Program,” stated U.S. Attorney Andrew Birge. “My office will come after false billing like that not only for the civil penalties but also for the treble damages as well to deter future cheating.”

“When medical providers increase profits by submitting false claims to Medicare, they unjustly enrich themselves and undermine the public’s trust in the medical profession,” said Special Agent in Charge Mario M. Pinto of the U.S. Department of Health and Human Services Office of Inspector General. “We will continue to work diligently with our law enforcement partners to protect the integrity of Medicare and the beneficiaries served by such federal health care programs.”