Settlement Reached in Medicare Fraud Case Involving Long-Term Care Providers

A New York-based long-term care therapy provider has agreed to a $315,000 settlement over allegations of conspiring with nursing facilities in Massachusetts and Connecticut to fraudulently extract funds from Medicare and Medicaid. This resolution comes after litigation by the state Attorney General's Office and the U.S. Attorney's Office against the group of facilities known as RegalCare and Stern Therapy Consultants.

The allegations assert that from January 1, 2017, to September 30, 2019, these companies manipulated documentation to inflate charges for long-term care services that were not medically necessary, violating regulatory compliance requirements. The settlement specifically addresses these accusations against Stern Therapy Consultants, according to the U.S. Attorney’s Office. Meanwhile, legal proceedings continue against RegalCare, its owner Eliyahu Mirlis, and executive Hector Caraballo.

RegalCare focuses on operating facilities that provide care to patients following hospital stays, with locations across numerous cities including Amesbury, Danvers, Greenfield, Harwich, Holyoke, Lowell, Quincy, Saugus, Taunton, and Worcester. These developments underscore the importance of compliance in healthcare operations, as insurers and providers face increasing scrutiny.