» Study Finds For-Profit Nursing Homes Lead in Overcharging

Study Finds For-Profit Nursing Homes Lead in Overcharging

White Plains, NY (Law Firm Newswire) February 25, 2013 - The nursing home industry has been over-billing Medicare.

According to federal inspectors, the nursing home industry is guilty of over-billing Medicare by $1.5 billion each year, charging for treatments and care that patients either do not need or never receive.

Research from the inspector general’s office of the U.S. Department of Health and Human Services found that more than 30 percent of claims from for-profit nursing home care centers were “padded,” either for care never given or not needed in the first place, a stark difference from the estimated nonprofit nursing homes pad rate of 12 percent.

For-profit medical care is a growing industry, taking up 78 percent of $105 billion in yearly nursing home revenue as of 2010, up from 72 percent in 2002. A 2012 Medicare Payment Advisory report found that for-profit providers “dominate most health care sectors”; health care researchers and Medicare overseers estimate that for-profit care billing fraud and waste is a major issue in the $2.8 trillion U.S. health care sector.

Since 2008, federal prosecutors have brought more than 120 civil and criminal cases against nursing homes and nursing-home related individuals, a doubling of the number of cases compared to the prior five years. For-profit care has expanded dramatically in most medical areas compared to the same care in the not-for-profit sector; for-profit hospice has grown at a rate 10 times faster than nonprofit hospice care from 2004 through 2009. For-profit outpatient surgery centers make up 96 percent of all such centers in the country, and 84 percent of all U.S. home-health care agencies are for-profit.

Nursing homes are responsible for employing more than 1.6 million care workers, second only to hospitals in the health care sector. Hospitals, meanwhile, are overwhelmingly still nonprofit: 88 percent of U.S. hospitals are nonprofit or government-run as of 2010, according to the U.S. Census Bureau.

Private investment and private ownership of medical facilities and medical care helps to push innovation and competition for quality care, according to advocates of private medical care, while critics contend that when medical care focuses on the bottom dollar, the quality of care can be at risk, especially for those without deep pockets.

About Littman Krooks
Littman Krooks LLP provides sophisticated legal advice and the high level of expertise ordinarily associated with large law firms along with the personal attention and responsiveness of smaller firms. These ingredients, which are the cornerstone of effective representation and necessary to a successful lawyer/client relationship, have become the foundation of the firm’s success.

Littman Krooks LLP offers legal services in several areas of law, including elder law, estate planning, special needs planning, special education advocacy, and corporate and securities. Their offices are located at 399 Knollwood Road, White Plains, New York; 655 Third Avenue, New York, New York; and 300 Westage Business Center Drive, Fishkill, New York. For more information about Littman Krooks LLP, visit the website at: www.littmankrooks.com.

New York Contact:
Maria M. Brill
Littman Krooks LLP
(914) 684-2100
[email protected]

New York City Office
655 Third Avenue, 20th Floor
New York, New York 10017
(212) 490-2020 Phone

Westchester Office
399 Knollwood Road
White Plains, New York 10603
(914) 684-2100 Phone

Dutchess Office
300 Westage Business Center Drive, Suite 400
Fishkill, NY 12524
(845) 896-1106 Phone


View Larger Map

  • When Not to Claim an Inheritance
    Although it may seem counter-intuitive to turn down an inheritance, there are situations in which it may actually be beneficial to do so. When a person refuses to accept an inheritance, that person is said to disclaim it, and the effect is the same as if the heir had predeceased the person who died. The […]
  • Settlement Reached for Seniors Who Must Leave Assisted Living Home
    An assisted living home for seniors in New York City is closing and five residents who had refused to move will accept a $3.35 million settlement. In March 2014, the management of a home for seniors in Brooklyn announced that the facility was closing and the residents would have to move within 90 days. Many […]
  • Medicaid Asset Transfers: What Are The Rules?
    For many families, paying for a loved one’s extended stay in a nursing home would be difficult without the help of Medicaid. However, in order to qualify for the program, a person’s income and assets must fall within certain limits. Federal rules state that to qualify for Medicaid nursing home coverage, a person must have […]

See other news sources publishing this article. BETA | Tags: , , , , , ,



Get headlines from Law Firm Newswire sent right to your inbox.

* indicates required