- November 22, 2024
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A Tampa company that provides physician services for assisted living, group homes and memory care units will pay nearly $15 million to settle allegations that it submitted false claims.
Bluestone Physician Services of Florida LLC, Bluestone Physician Services P.A., and Bluestone National LLC — which operate in Florida, Minnesota and Wisconsin, respectively — agreed to pay $14,902,000 over allegations that they submitted claims for chronic care management and visiting established patients in rest homes when they had not provided those services, according to a statement from the U.S. Department of Justice. The claims were submitted to Medicare, Medicaid and TRICARE.
Federal officials say that the false claims were submitted from 2015 to 2019.
A Bluestone spokesperson, in an emailed statement to the Business Observer, says the case did not impact patient care.
“Bluestone’s highest priority is providing excellent care to our patients, who are among our nation’s most vulnerable, and we take compliance with all laws and regulations governing our industry very seriously," the June 8 email states. "Nothing about this matter relates to the efficacy of the health care we provide, which has improved our patients’ care outcomes and has not been called into question. Rather, the allegations relate to medical record documentation issues that occurred under prior management between 2015 and 2019. While we deny the allegations, we have agreed to this settlement so we can focus exclusively on bringing effective, high-quality care to the fragile and medically complex patients who rely on us.”
Former General Manager for Bluestone’s Florida market, Lisa Loscalzo, brought her concerns about the improper coding of services to light under the whistleblower provisions of the False Claims Act and as a result, will receive $2,831,380 in connection with the civil settlement, officials say.
As a result of the settlement, the federal government will receive $13,842,482, while the states of Florida and Minnesota will receive $1,059,518, according to a statement from the justice department.
“This resolution sends a message to the provider community and to our district that we will actively investigate and prosecute this kind of conduct whenever it appears," U.S. Attorney Roger B. Handberg for the Middle District of Florida says in a statement.
As part of the settlement, Bluestone has entered into a five-year corporate integrity agreement with the U.S. Department of Health and Human Services’s Office of Inspector General. The agreement requires the company to establish a compliance program and submit to an independent review of its Medicare claims to determine whether the claims were medically necessary, appropriately documented and correctly coded, according to a statement.
Officials say the U.S. Justice Department and U.S. Attorneys’ Offices for the District of Minnesota and the Middle District of Florida were involved in the case, with assistance from the Office of Inspector General, Defense Criminal Investigative Service and FBI.
This story was updated to include a statement from Bluestone.
