US Law – LawFuel, The Legal News Network – SAN FRANCISCO – United States Attorney Kevin V. Ryan announced that Parkview Nursing Center Inc. in San Jose, Calif., pleaded guilty and was sentenced today to two criminal counts of submitting falsely inflated cost reports to Medicare. Parkview Nursing Center owned and operated a Horizon West Inc. nursing home in San Jose. As part of the sentence Judge Saundra Armstrong ordered Parkview to pay a $500,000 fine. As part of a related civil settlement that was signed on August 25, 2006, Horizon West, Inc., and its wholly owned subsidiary Horizon West Healthcare, Inc. agreed to pay $14.7 million to settle civil allegations that they violated the civil False Claims Act.
The United States alleges that Horizon West, Inc., and Horizon West Healthcare, Inc, which run a nursing home chain with about 30 facilities in California and Utah, falsely inflated the number of nursing hours spent on Medicare patients when reporting their nursing costs to the Medicare program from 1991 to 1998. The $14.7 million settlement and criminal guilty plea today will resolve the case.
“Health care fraud has long been one of my priorities. This office will continue to vigorously investigate allegations of false claims against Medicare. It is essential that we do our part to safeguard the limited monies in the Medicare Trust Fund,” said Kevin V. Ryan, United States Attorney for the Northern District of California.
The settlement resolves the civil case United States ex rel. Lee v. Horizon West Inc., et al., which was filed in 2000 by former Horizon West employee Julia Lee. Lee filed the case pursuant to the qui tam provisions of the False Claims Act, 31 U.S.C. §§ 3729-33. Those provisions authorize private parties to file lawsuits under seal alleging False Claims Act violations on behalf of the United States. The United States intervened in the case on June 24, 2005, and the U.S. District Court in Oakland unsealed the case on July 11, 2005. The United States filed its complaint in the case on October 21, 2005.
Sara Winslow and Steve Saltiel are the Assistant U.S. Attorneys who handled the civil settlement, together with Department of Justice Civil Division Trial Attorney Suzette Gordon, and with the assistance of Financial Fraud Investigator Wayne Yee and Paralegal Specialist Maryam Beros. Maureen Bessette is the Assistant U.S. Attorney who prosecuted the criminal case with the assistance of Cynthia Daniel. This settlement is the result of an investigation by the United States Department of Health and Human Services, Office of Inspector General and the Federal Bureau of Investigation.