On August 17, 2026, the U.S. Attorney’s Office for the Western District of New York announced that New York-based Safire Rehabilitation agreed to pay $9 million to resolve allegations under the federal and New York False Claims Acts involving skilled rehabilitation therapy billed to Medicare and Medicaid.
The government alleges that for a period of approximately four-and-a-half years Safire submitted claims for skilled rehabilitation therapy that was not reasonable or necessary, supported by medical-record documentation, documented as provided, or provided at all. The DOJ specifically alleges that Safire scheduled therapy and set treatment goals according to insurer reimbursement policies rather than residents’ medical needs; pressured therapists to provide therapy despite recommendations against it; pressured residents to attend sessions after repeated refusals; and manufactured or altered therapy referrals and medical records to justify unreasonable and unnecessary services.
The settlement resolves a qui tam action filed by a former Safire employee.
Skilled nursing facilities should ensure that therapy intensity, duration, goals, and discharge decisions reflect individualized clinical judgment rather than reimbursement opportunities. Compliance testing should compare therapy schedules and billed units with physician orders, therapist recommendations, resident participation, functional progress, and contemporaneous documentation.
Facilities should also protect clinicians from productivity or utilization pressure that could override medical judgment, audit records for late changes or unsupported referrals, and investigate patterns of repeated refusals or services billed but not documented. The allegations reinforce that documentation controls must confirm both that therapy was medically necessary and that the billed service was actually provided.
GWB represents healthcare providers in connection with government investigations and False Claims Act litigation. If you need assistance with such a matter, contact us today.
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