Home Health & Hospice Week

Whistleblower rakes in $2.3 million.

Be sure to toe the line in your relationships with institutional referral sources, or you could both get in trouble.

Long-term care and rehabilitation hospital chain Post Acute Medical is learning that lesson in a $13.2 million settlement sparked by a whistleblower lawsuit. Enola, Pennsylvania-based PAM violated the Antikickback Statute “by entering into what it called ‘reciprocal referral relationships’ with unaffiliated healthcare providers such as home health companies,” the Department of Justice says in a release. “PAM allegedly referred patients to those other providers with the understanding that those providers would refer other patients to PAM’s facilities.” The settlement also covers charges that PAM paid kickbacks to physicians through sham medical director relationships for its hospitals.

Whistleblower Douglas Johnson will receive more than $2.3 million as part of the settlement, the DOJ says.

Other recent fraud case developments include:

In California: In another case hinging on kickbacks, physician Kanagasabai Kanakeswaran has been convicted by a Los Angeles federal jury of kickback charges. From 2008 to 2016, Kanakeswaran referred Medicare patients to Star Home Health Resources in La Verne in exchange for illegal kickbacks. Kanakeswaran received both cash kickbacks and checks via his Digital Perfection Corporation company, the Department of Justice says in a release. Medicare paid Star about $4.1 million in the scheme, which was investigated by the Medicare Fraud Strike Force. Kanakeswaran is scheduled to face sentencing Jan. 7.

In Michigan: Physical therapist Jimmie James Anthony has pleaded guilty to billing Medicare for PT services through his home care company, West Shore Comfort Home Care Services in Norton Shores, that were never provided, reports MLive.com. Anthony entered a plea bargain under which he could face up to a year in jail and $100,000 in fines. According to the plea agreement, West Shore received nearly $20,000 in Medicare reimbursement for the services.