U.S. ex rel. John Doe v. Recovery Home Care, Mark Conklin, and Glen Castillo
Home healthcare is a wide range of healthcare services that can be given in your home for an illness or injury. Under Medicare, the United States pays for certain home health services rendered to Medicare beneficiaries who meet specific coverage requirements.
In paying for these services, Medicare depends on physicians to exercise independent judgment in the best interests of patients. Financial incentives tied to referrals have a tendency to corrupt the health care system in ways that harm programs and their beneficiaries. Unfair competition can result when honest providers have difficulty competing with unscrupulous providers who pay to generate business. This results in systemic corruption of healthcare programs and defrauding of the public.
In the case against RHC, the whistleblower provided information detailing how RHC was paying physicians to refer Medicare patients to RHC for home health services in violation of the AKS, Stark Law and False Claims Act; thereby defrauding the public.
On March 9, 2015 the case settled against Recovery Home Care for $1.1 million. The case settled against individual defendant Mark Conklin for $1.75 million in March 2016.