Knowledge base

Comprehensive Outpatient Rehabilitation Facility (CORF) Fraud

a CORF is an outpatient facility established and operated exclusively for the purpose of providing diagnostic, therapeutic, and restorative services for the rehabilitation of injured, disabled, or sick persons, at a single fixed location, by or under the supervision of a physician. CORFs are different from other therapy providers in that, in addition to physical therapy, regulations require that they offer psychological or social services and the services of a physician who specializes in rehabilitation medicine. They are also unique in their authority to provide a variety of nontherapy services—such as respiratory treatment or nursing care—as medically necessary in the context of a patient’s rehabilitation therapy treatment plan. In general, services are provided on the CORF premises at a single, fixed location. Back disorders, arthritis, soft tissue injuries (such as joint sprains and strains), and neurologic disorders (such as concussion) are common conditions treated at CORFs. Common fraud patterns at CORFs revolve around overutilization of services, including billing for medically unnecessary therapy services (such as for therapy services related to maintaining rather than improving a patient’s functioning),and claims for the same beneficiary made by more than one CORF (often with common ownership so as to avoid scrutiny by spreading out the claims).

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