A sham medical director arrangement is at the center of a Texas home health fraud case. Teresita Lumanas Alquero, former owner of Providence Home Health and Providence Hospice in Houston, will pay $1.05 million to settle charges that she paid a physician medical directorship payments that “exceeded fair market value and were paid over a two-year period to induce him to refer Medicare patients,” the Department of Justice says in a release. Lumanas Alquero also agreed to a five-year exclusion from Medicare and other federal health care programs.
Lumanas Alquero also identified an attending physician on claims who was actually incarcerated during that time and whose medical license was suspended, the DOJ alleges. The settlement was sparked by a 2017 whistleblower lawsuit filed by two former employees, Justice adds. The qui tam relators will share $168,000 from the settlement.