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2 health care providers, dozens of people charged in alleged $115M Medicare kickback scheme

Two well being care suppliers and 28 individuals – together with one of many supplier’s CEOs, 13 medical doctors, 5 nurses and a social employee – have been charged with involvement in a $115 million Medicare kickback scheme in California, the Justice Division introduced Thursday.

Amity Residence Well being Care was stated to have bribed greater than two dozen defendants with kickbacks disguised as payroll, phony medical directorships, “reimbursements,” “entertainment” or “gifts” in order that they would make referrals to Amity and hospice supplier Introduction Care, which in flip might invoice for these companies, prosecutors stated. Amity Residence Well being Care is the most important residence well being care supplier within the San Francisco Bay space, the DOJ stated.

“The complaints allege a scheme for doctors, nurses and other medical care professionals to trade patients for cash,” U.S. Legal professional David Anderson stated. “This is the largest cash-for-patients scheme ever charged criminally in the Northern District of California.”

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Prosecutors stated Amity CEO Ridhima “Amanda” Singh allegedly bribed “marketers” with money and presents, and instructed them “to take purchasers out to elaborate meals, sporting occasions and buy presents for people keen to supply Amity with sufferers.” These have been primarily sufferers on Medicare, the federal well being program for individuals 65 and older.

“When patient referrals were slow, Singh allegedly directed the marketer to incentivize clients with gifts in an effort to induce them to refer more patients to Amity,” the DOJ stated.

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Each single defendant was recorded as providing, accepting or approving the kickbacks for referrals, in response to complaints.

“The transition to a home health agency should be based on medical and personal needs – not cash payments or thinly disguised referral bribes as alleged in these cases,” stated FBI Particular Agent in Cost Steven Ryan. “We will continue working with law enforcement partners to guard these vital government health programs, as patients and taxpayers deserve better.”

Every of the defendants was charged with illegally influencing affected person referrals for federally funded well being care by means of funds, the DOJ stated. As well as, Singh was charged with mendacity to investigators and tampering with witnesses.

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If discovered responsible, the defendants will resist 10 years in jail and a most $500,000 high quality. Singh might additionally face a statutory penalty of as much as 5 years in jail and a $250,000 high quality for mendacity to investigators, in addition to a statutory penalty of as much as 20 years in jail and one other $250,000 high quality for tampering with witnesses.

For every violation, the firms can be topic to a $1 million high quality.

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