Top Provider HCR Manor Care May Have Been Paid Nearly $260 Million Above Expected in 2009

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New research from the nation's largest union of long term care workers shows that fraudulent Medicare billing spotlighted in a report by the Department of Health and Human Services may be continuing at major nursing home chains including, for example, HCR Manor Care and North American Health Care.

In December 2010, the Office of the Inspector General at the Department of Health and Human Services issued a report ("Questionable Billing by Skilled Nursing Facilities") that highlighted skyrocketing increases in potentially fraudulent billing of Medicare by skilled nursing facilities (SNFs) between 2006 and 2008.

New analysis by the Service Employees International Union details a continuing increase in Medicare reimbursement through 2009 and names the top fifteen with the most questionable billing.

"This research shows that nursing home companies may be continuing to take advantage of Medicare by billing for care that wasn't provided or clinically necessary," said Mary Kay Henry, President of SEIU. "American taxpayers can't keep giving more money to the nursing home industry without real accountability and better results."

Sitting high atop the list of those with questionable billing is HCR Manor Care, one of the largest skilled nursing home companies in the nation. In 2009, HCR Manor Care billed Medicare for nearly $260 million in questionable charges. Next on the list was North American Health Care, which received over $40 million in questionable reimbursements in 2009.

A March 28, 2010 Washington Post article described the troubling billing pattern at North American Healthcare and reported that, "(a) separate division of the HHS inspector general's office is investigating North American Health Care, which operates 35 facilities, most of them in California."

Henry applauded the OIG's report and the agency's continuing efforts to safeguard Medicare.

"Through its actions, the OIG is showing a real commitment to rooting out waste, fraud and abuse in our Medicare system. This is exactly the kind of leadership that hard-working families are counting on. And we urge OIG to continue in this effort and to call on nursing home companies like North American Health Care and HCR Manor Care to account for the bills they submit to the American people for payment."

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With 2.2 million members in Canada, the United States and Puerto Rico, SEIU is the fastest-growing union in the Americas. Focused on uniting workers in healthcare, public services and property services, SEIU members are winning better wages, healthcare and more secure jobs for our communities, while uniting their strength with their counterparts around the world to help ensure that workers--not just corporations and CEOs--benefit from today's global economy. www.SEIU.org

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