Major Sacramento skilled nursing home to pay $450K fine in Medicare overbilling case

The operator of a major skilled nursing facility in Sacramento is paying a $451,439 fine to resolve charges that it overbilled the government for Medicare services.

Plum Healthcare Group LLC, which operates McKinley Park Care Center, agreed to the civil settlement with the U.S. attorney’s office in Sacramento.

Federal officials said Plum Healthcare is the second-largest operator of skilled nursing facilities in California.

Acting U.S. Attorney Phillip Talbert’s office had accused the center of creating false billing records to obtain “Medicare reimbursements that were higher than warranted.” The higher charges — for occupational and physical therapy — covered a three-year period ending in late 2015, according to court records.

“It’s unacceptable to stick taxpayers with a bill for healthcare services that were never provided and for healthcare executives to look the other way when these false claims were submitted to Medicare,” said Steven Ryan, an agent with the U.S. Department of Health and Human Services, in a prepared statement.

The case originated when a former employee sued the company in 2016. The ex-employee, a physical therapist named Kristine Davenport, will receive $90,000 of the settlement as her share under the “whistleblower provisions” of the federal False Claims Act, according to court records.

Executives of Plum Healthcare, based in Southern California, couldn’t be reached for comment. In the settlement agreement, the company didn’t admit to any wrongdoing.

The settlement was dated June 14 but not announced until Tuesday.

This story was originally published June 29, 2021 at 1:48 PM.