Recovery Home Care and National Home Care Holdings will pay the government $1.1 million to resolve claims that Recovery Home Care paid doctors for home health care patient referrals. Recovery Home Care, which provided home health care services to Medicare beneficiaries, was purchased by National Home Care in 2012. The alleged fraud occurred prior to the sale.
The settlement resolves allegations initially filed by whistleblower Gregory Simony, a former Recovery Home Care employee. The government decided to intervene in Simony’s qui tam lawsuit, and for his courage to come forward, he will receive a whistleblower reward totaling nearly $200,000.
According to Simony’s claims, West Palm Beach, Florida-based Recovery Home Care allegedly paid thousands of dollars to dozens of doctors between 2009 and 2012. Recovery Home Care made the payments under the guise of patient chart reviews, but in reality, the money was used to induce doctors into referring patients to Recovery Home Care, a violation of both the Anti-Kickback Statute and the Stark Law.
The Anti-Kickback Statute and the Stark Law are intended to prevent a doctor’s judgment from being compromised by improper financial incentives. The Anti-Kickback Statute prevents offering, paying, soliciting or receiving remuneration in exchange for referrals of services or items that are covered by government health care agencies. The Stark Law prohibits a home health care provider from billing Medicare for services referred by a doctor with whom the provider has a financial relationship.
The settlement resolves claims against Recovery Home Care, but not that of its former owner, Mark Conklin. The Justice Department is still litigating against Conklin for his role in the scheme.
It’s a shame that companies like Recovery Home Care feel like they can break the law at the expense of government health care agencies and taxpayers. Thankfully, there are people out there like Mr. Simony who are willing to expose wrongdoing by blowing the whistle on fraud.