Florida Skilled Nursing Facility, Physician, and Related Providers Will Pay $1.5 Million in an Illegal Kickback and Patient Referral Scheme
Participating in patient-physician referral schemes in violation of the Stark Law and the Anti-Kickback Statute can result in liability under the False Claims Act.
Compliance Perspective – Kickback
Policies/Procedures: The Compliance and Ethics Officer with the Administrator and Medical Director will review policies and procedures prohibiting patient-physician referral kickback schemes.
Training: The Compliance and Ethics Officer with the Administrator and Medical Director will ensure that appropriate staff and physicians are trained to respond in a timely manner to concerns about possible patient-physician referral kickback schemes.
Audit: The Compliance and Ethics Officer should periodically and personally conduct an audit of newly admitted residents in order to determine if there are indications of patient-physician referral kickback schemes.
A Florida skilled nursing home, its former administrator, and the management company, as well as an orthopedic surgeon and others have agreed to pay $1.5 million to resolve allegations regarding a Medicare and TRICARE patient-physician referral kickback scheme. The scheme was said to disguise intricate kickback arrangements through directorships and other misrepresented positions.
The government alleged that the defendants were involved in financial arrangements that violated the physician self-referral law, commonly known as the “Stark Law,” and the Anti -Kickback Statute which created liability under the False Claims Act.
Pursuant to two separately executed settlement agreements, the orthopedic surgeon has agreed to pay $500,000, and Conway Lakes, Clear Choice, Cleveland, Fraser, and File have agreed collectively to pay $1 million to the United States.
The allegations resolved by the settlement agreements were originally brought in a lawsuit filed by a former employee of Conway Lakes, under the qui tam, or whistleblower, provisions of the False Claims Act. The Act permits private citizens with knowledge of fraud against the government to bring an action on behalf of the United States and to share in any recovery.
