Home Health & Hospice Week

Government pursues agency over sham jobs for physicians’ spouses.

Add another case to the list of costly whistleblower lawsuits.

The government has intervened in a qui tam lawsuit against Fort Lauderdale, Fla.-based A Plus Home Health Care Inc. and its owner Tracy Nem-erofsky, the Justice Department says in a release. "A Plus offered referring physicians’ spouses sham marketing positions with the company to induce the physicians to refer Medicare patients for home health care services," the government alleges in the case filed by former A Plus director of development, William Guthrie.

Starting in 2006, "the company allegedly hired at least seven physicians’ spouses and one physician’s boyfriend to perform marketing duties but required them to perform few, if any, actual job duties," the DOJ claims. "To cover up the scheme… Nemerofsky generated sham personnel files, which included lists of job duties the spouses and boyfriend did not perform and performance reviews of job functions they did not complete, to give the false impression that the spouses and boyfriend were legitimate employees."

The result: The physicians’ referrals to A Plus spiked dramatically when the spouses and boyfriend began receiving paychecks from the agency, prosecutors say. "In 2005, before A Plus hired any referring physicians’ spouses, A Plus was allegedly reimbursed $1.1 million from Medicare," the feds note. "Conversely, in 2011, when A Plus was paying salaries to the seven referring physicians’ spouses and one physician’s boyfriend, A Plus’ Medicare reimbursement allegedly reached an all-time high of $6.6 million."

Fraud spotlight: The feds seem to be using the opportunity to paint the entire industry as suspicious. "Home health services are particularly vulnerable to fraud, waste and abuse," the DOJ claims in the release. "In 2010, Medicare paid a reported $19.5 billion to 11,203 home health care agencies for services provided to 3.4 million beneficiaries."

The government has previously settled with two of the couples that accepted payments from A Plus, it says.