United States Intervenes in Home Health Care Fraud Case
Last week, the United States intervened in a lawsuit brought against Florida-based Doctor’s Choice Home Care and its two owners. The Department of Justice alleged that the company bribed doctors to refer patients in violation of the federal Anti-Kickback Statute and Stark Law. Both laws prohibit medical providers from paying or receiving kickbacks in connection with government-funded health care programs.
According to federal prosecutors, Doctor’s Choice offered sham medical directorships to physicians with the potential to refer large numbers of patients for home health services. The physicians allegedly preformed no services as medical directors; the directorships were merely a way to funnel cash to physicians in exchange for patient referrals. One physician with a directorship allegedly referred 631 patients to Doctor’s Choice, resulting in more than $1.8m in Medicare payments. Doctor’s Choice also allegedly hired the wives of high-referring physicians, and paid those wives based on the volume and value of their husbands’ patient referrals.
The lawsuit was originally brought by a whistleblower, a former Doctor’s Choice sales representative, under the qui tam provision of the False Claims Act. The FCA’s qui tam provision incentivizes individuals to come forward and report fraud against the government by awarding the whistleblower a share of any monetary recovery.
After investigating the whistleblower’s allegations against Doctor’s Choice for nearly four years, the federal government officially joined the case by filing a complaint to intervene. The likelihood that an FCA case will succeed increases substantially when the government intervenes. In filing their complaint in intervention, U.S. Attorney Maria Chapa Lopez emphasized that “kickbacks and other improper remuneration that interferes with the medical decision-making process undermines the integrity of our health care system.”
- Anti-Kickback Statute and Stark Law
- False Claims Act
- Home Health and Hospice
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