Home Health Agency, Former Executives to Pay $5.8 Million to Settle FCA Allegations
December 11, 2020 | Aging Services Risk Management
A home care agency and two former executives have agreed to pay a total of $5,825,000 to resolve False Claims Act (FCA) allegations involving improper inducements to physicians, bonuses for employees based on referrals by their physician spouses, and pressure on clinical personnel to increase the number of home care visits for Medicare patients, according to a November 20, 2020, news release from the U.S. Department of Justice.
The home care agency will pay $3,856,000, and the two former executives will each pay $647,000, to settle allegations that it provided improper financial inducements to referring physicians by executing sham medical-director agreements and paying bonuses to agency employees whose physician spouses referred patients to the agency. The sham medical agreements violated the Anti-Kickback Statute and the Stark Law, and the bonuses violated the Stark Law. The home care agency will also pay $675,000 to settle allegations that its employees pressured clinical personnel to increase the number of home care visits for Medicare patients to escape the Medicare Low Utilization Payment Adjustment. When a home health patient has received fewer than five skilled service visits, this adjustment applies, and...