OAKLAND - The Service Employees International Union-United Healthcare Workers West (SEIU-UHW) today called on California Attorney General Edmund G. Brown to investigate potential overbilling of the Medi-Cal program by North American Health Care, Inc. (NAHC), a nursing home chain with 29 facilities in California, in light of the operator's apparent overbilling of Medicare by $100 million.
"North American Healthcare is a rogue company that has likely been overbilling Medicare of funds that should go to care for nursing home residents who need services 24 hours a day and may be doing the same thing to Medi-Cal," said Dave Regan, SEIU-UHW Trustee. "The attorney general should investigate swiftly and prosecute if that's the case."
According to research conducted by SEIU-UHW and corroborated by a March 29 Washington Post article, "Review heightens concerns over Medicare billing at nursing homes" (please click here to view the article), NAHC appears to have overbilled Medicare by $100 million over the past five years. The office of U.S. Rep. Pete Stark (D-CA) responded to the research by requesting that the Office of the Inspector General of the U.S. Department of Health and Human Services investigate the findings, and the Post reported that a federal investigation is underway.
NAHC may be committing the same alleged overbilling of Medi-Cal as it is did Medicare, according to SEIU-UHW analysis of public data. Over the past five years, NAHC facilities have billed California' Medi-Cal program for ancillary services including medical supplies, certain drugs, and physical and occupational therapy services at rates nearly three and a half times above the state median for non-specialty nursing homes. SEIU-UHW's analysis found that between 2004 and 2008, NAHC facilities reported billing that exceeded state medians by $6.3 million.
SEIU-UHW has also asked legislators with NAHC facilities in their districts to support an investigation by the Office of the Attorney General's Bureau of Medi-Cal Fraud and Elder Abuse. California NAHC facilities are located in Anaheim, Baldwin Park, Carmichael, Chatsworth, Woodland, Danville, El Monte, Fairfield, Fullerton, Grand Terrace, Huntington Beach, Lodi, Lomita, Long Beach, Pacific, Petaluma, Riverside, Sacramento, Santa Monica, Sebastopol, Signal Hill and Van Nuys.
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SEIU-United Healthcare Workers West, SEIU (SEIU-UHW) is the largest hospital and healthcare union in the western United States with more than 150,000 members. We unite every type of healthcare worker with a mission to achieve high-quality healthcare for all. SEIU-UHW is part of the 2.2 million-member Service Employees International Union (SEIU), the nation's fastest-growing union. Learn more at www.seiu-uhw.org.