Healthcare Compliance Perspective:
The Federal Anti-Kickback Statute 42 U.S.C. § 1320a-7(b) strictly prohibits a healthcare provider receiving or offering to pay any remuneration of any kind in exchange for referring any individual to a healthcare facility that results in reimbursement for services and/or products from federal health care programs. Referral sources must provide bona fide services in exchange for fair market value with appropriate documentation.
ATLANTA – A hospice care group has agreed to pay $2.4 million to resolve allegations that it and its subsidiary submitted or caused the submission of false claims to Medicare and Medicaid by engaging in improper financial relationships with contracted physicians. The hospice care group is a Florida corporation with its principal place of business in Parsippany, New Jersey, and with subsidiaries and affiliates in numerous states.
The government alleges that, between April 3, 2007 and April 29, 2011, the hospice group and its affiliates in Atlanta paid illegal remuneration to five physicians in order to induce the providers to refer patients to them for hospice services and to certify individuals as eligible for hospice services. The hospice care group is alleged to have submitted or caused the submission of claims to Medicare and Medicaid for services provided to the individuals who had been referred by the physicians because of the kickbacks. The illegal remuneration took the form of payments to a medical director in exchange for referrals, and sham contracts with associate medical directors in exchange for referrals.
The settlement resolves allegations filed by former employees, under the qui tam, whistleblower, provisions of the False Claims Act.
