Home Health & Hospice Week

Beware: The feds may be examining your employee roster.

The feds continue to demonstrate their willingness to go after more than just home care providers in home health-related schemes.

In South Florida, two physicians and their wives have agreed to pay $1.13 million to settle allegations that they violated the False Claims Act when their wives accepted sham marketer salaries in ex-change for their husbands’ referrals to home health agency A Plus Home Health Care Inc., the Justice Department says in a release.

Dr. Alan and Lynn Buhler will pay $1.047 million and Dr. Craig and Cynthia Prokos will pay $90,000, the DOJ says. “The spouses were required to perform few, if any, of the job duties they were allegedly hired for and instead, the spouses’ salaries were intended as an inducement for the husband physicians to refer their Medicare patients to A Plus,” the DOJ alleges. “Alan Buhler received medical director payments as part of A Plus’s scheme to obtain his referrals and he attempted to hide those payments from the United States.”

The government previously settled with A Plus, owner Tracy Nemerofsky and five other couples that allegedly accepted payments from A Plus (see Eli’s HCW, Vol. XXIII, No. 33).

“The settlement announced today is another example of the Justice Department’s unrelenting efforts to hold accountable those who engage in kickback schemes,” said U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida.

The case started as a whistleblower lawsuit by former A Plus director of development William Guthrie.

“Physicians who engage in such in-your-face kickback schemes to refer Medicare patients to certain home health companies in exchange for money will be held accountable for their behavior,” says HHS Office of Inspector General Special Agent in Charge Derrick L. Jackson in the release. “Our agency will continue to crack down on kickbacks, which undermine impartial medical judgment, corrode the public’s trust in the health care system and waste scarce Medicare funding.”

Similarly: A Detroit area doctor has been sentenced to 15 months in prison and $1.3 million in restitution after pleading guilty to Medicare fraud. Dr. Paula Williamson admitted to signing referrals for HHA AMB Healthcare Inc. in Farmington Hills. She falsified medical documentation and certified Medicare beneficiaries as homebound when she had never examined nor even met the beneficiaries, the DOJ says in a release