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Elderwood agrees to pay $950,000 to resolve allegations of fraudulently billing for Medicare and Medicaid

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Posted at 5:31 PM, Aug 02, 2022
and last updated 2022-08-02 17:31:03-04

BUFFALO, N.Y. (WKBW) — The U.S. Attorney's Office announced Elderwood has agreed to pay $950,000 to resolve allegations of fraudulently billing for Medicare and Medicaid.

According to Assistant U.S. Attorney David M. Coriell, between August 1, 2013, and December 31, 2018, Elderwood allegedly knowingly submitted or caused to be submitted, false claims for payment to Medicare for physical therapy, occupational therapy, and speech therapy services that were medically unnecessary. As a result, Elderwood received "artificially inflated payments from Medicaid."

“This settlement reflects the commitment of my office to hold everyone, including healthcare providers, accountable when they seek to defraud the government. My office will continue to ensure that federal taxpayer dollars meant to serve Medicare and Medicaid patients are spent on needed services and we will not allow healthcare providers to become unjustly enriched when they bill for unnecessary services.”
- U.S. Attorney Trini E. Ross

Elderwood released the following statement:

Elderwood Administrative Services, LLC has reached an agreement with the U.S. Department of Justice (DOJ) and the U.S. Department of Health & Human Services Office of Inspector General (OIG) to settle a complaint filed by a former employee, whose employment terminated in 2014, alleging inappropriate billing. The allegations relate to historical periods between 2013 and 2018 at specific Elderwood facilities including: Elderwood at Amherst; Elderwood at Cheektowaga; Elderwood at Grand Island; Elderwood at Hamburg; Elderwood at Lancaster; Elderwood at Liverpool; Elderwood at Waverly; Elderwood at Wheatfield; and Elderwood at Williamsville.

Although, in its settlement with DOJ and OIG, Elderwood did not admit any of these allegations, litigating the matter would likely exceed the amount of the fines imposed. “Defending these types of subjective allegations of overutilization in court requires an unsustainable allocation of resources that we believe are better used to enhance resident care,” said Chuck Hayes, Vice President of Marketing and Communications for Elderwood.

The settlement is not an admission of guilt and the former employee’s complaint remains a set of allegations and not a statement of fact.

Elderwood remains committed to its core values of integrity, collaboration, accountability, respect, and excellence and providing high quality healthcare in a safe, vibrant environment.