There are three laws in place to address the impropriety of doctor kickbacks: the False Claims Act, the Anti-Kickback Statute, and the Stark Law. These are three pieces of federal legislation enacted to punish and deter intentional fraud involving taxpayer funds. In the context of healthcare fraud, the acts are often triggered when intentional fraud and lucrative kickbacks occur pertaining to patients receiving government healthcare benefits, including Medicare, Medicaid, and the military’s TRICARE.
At the most basic level, patients have the right to receive unbiased medical advice from their doctor without the taint of financial incentive looming in the exam room. Patients should be able to listen to their doctor’s advice, follow their referral, or fill a prescription without wondering, “What’s in it for my doctor?” As such, the laws mentioned above work to ensure that any doctor found to be receiving kickbacks or referring patients to entities that they themselves own – and any entity found to be offering kickbacks – is required to answer for that conduct in the form of significant civil penalties and possible treble damages.
Today we look one of our own cases to review a prime example of unlawful doctor kickbacks, which, as the facts reveal, placed long-term care patients in grave danger of major oversights in their care plans. If you are aware of conduct similar to that described below, we encourage you to report it immediately, as you might save a life.
Details of the case against Recovery Home Care
As the Baby Boomer population continues to age, long-term care needs continue to climb, particularly in retirement havens like Florida. According to recent allegations unsealed by the Department of Justice, South Florida-based Recovery Home Care was involved in several years’ worth of illegal kickback conduct involving its long-term care patient base.
For a period spanning from 2009 through 2012, the company offered substantial compensation to doctors to perform patient chart reviews. The government alleges that doctors were grossly over-compensated for this work and the chart review payments were actually thinly-veiled disguises for financial inducements designed to increase referrals to the centers from the doctors. While the amount actually paid to each doctor has not been publicly disclosed, Recovery Home Care has agreed to remit $1.1 million to the federal government to reimburse it for the intentional fraud involving long-term care Medicaid patients.
The case against Recovery Home Care was filed in federal district court in Tampa, Florida by a former employee of the company under the False Claims Act’s qui tam provisions. Thereafter, the government opted to intervene in a part of the case, and the whistleblower ultimately received a recovery reward of $198,000.
The U.S. Attorney General’s Office said in a statement, “Health care providers that attempt to profit by providing illegal inducements will be held accountable….We will continue to advocate for the appropriate use of Medicare funds and the proper care of our senior citizens.”
Contact Berger & Montague, P.C. today
If you are aware of any suspicious financial activity involving government healthcare enrollees, we encourage you to contact our office right away to discuss your rights under the False Claims Act’s qui tam provisions.