Intermountain Healthcare has agreed to pay $25.5 million to resolve allegations that committed several Stark Law violations over the course of more than a decade. The Stark Law prohibits payments to doctors that could influence their referrals. Intermountain, the largest health system in Utah, self-disclosed its Stark law violations in 2009, admitting that it may have illegally paid bonuses to 37 doctors based on how much the system earned from their patient referrals and that more than 170 doctors were compensated without written contracts in various ways, including the rental of various office spaces without valid written leases. Intermountain’s disclosures prompted potential False Claims Act liability which led to the $25.5 million settlement.
On April 1, 2013, a patient recruiter for a Miami health care company was sentenced to serve 36 months in prison for his participation in a $20 million home health Medicare fraud scheme. Vladimir Jimenez had pleaded guilty in January 2013 to one count of conspiracy to receive health care kickbacks. His convictions stemmed from charges that, as a patient recruiter for Serendipity Home Health, he had solicited and received kickbacks and bribes from Serendipity in return for allowing Serendipity to bill the Medicare program for home health care and therapy services that were medically unnecessary and/or not provided. According to the U.S. Department of Justice, Jimenez’s participation in the illegal scheme resulted in more than $400,000 of fraudulent Medicare billings for purported home health care services.
On March 29, 2013, the owner and the director of a Louisiana home health agency were each convicted of conspiring to defraud Medicare of $17.1 million. Louis Age, who owned and operated South Louisiana Home Health Care Inc., and his former wife, Verna Age, who acted as the company’s director of nursing were each convicted of one count of conspiracy to commit health care fraud. Louis Age was also convicted of one count of conspiracy to defraud the United States and to pay and receive illegal health care kickbacks. Verna Age had previously been convicted in this case of one count of conspiracy to defraud the United States and to pay and receive illegal health care kickbacks.
The convictions were based on evidence that Louis and Verna Age paid recruiters to obtain Medicare beneficiary information, hired and paid medical doctors to sign referrals and certifications for home health services that were not medically necessary, and falsified evaluations and other forms to make it appear that the home health services were medically necessary, all of which resulted in $17.1 million of fraudulent Medicare billings for home health care claims between 2005 and 2011.
Sentencing dates have not yet been scheduled, but the conspiracy to commit health care fraud count carries a maximum potential penalty of 10 years in prison and a $250,000 fine, and the conspiracy to pay health care kickbacks carries a maximum penalty of five years in prison and a $250,000 fine.
Fluor Corp. recently agreed to pay $1.1 million to settle a whistleblower lawsuit accusing it of improperly using federal money to lobby for new government customers for the U.S. Department of Energy’s HAMMER training facility from 2005 to 2008. The whistleblower lawsuit was initiated by a former contracting official for HAMMER in 2011, but was subsequently taken over by the federal government. The relator will receive $200,000 of the $1.1 million settlement.
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