Florida-based Hebrew Homes Health Network Inc. has agreed to pay $17 million to resolve allegations it violated the False Claims Act by improperly paying doctors for referrals of Medicare patients requiring skilled nursing care, the US Dept. of Justice said.
The settlement is the largest to involve alleged violations of the Anti-Kickback Statute by skilled nursing facilities in the United States, the DOJ said in a statement Tuesday.
It also resolves allegations by Stephen Beaujon, a former CFO of Hebrew Homes, under the whistleblower provisions of the FCA, which permits private individuals to sue on behalf of the government for false claims and to share in any recovery. Beaujon will receive $4.25 million.
Since January 2009, the DOJ said it has recovered a total of more than $24.3 billion through FCA cases, with more than $15.3 billion of that amount recovered in cases involving fraud against federal health care programs.
From 2006 through 2013, the provider of skilled nursing services allegedly operated a sophisticated kickback scheme in which it hired numerous physicians ostensibly as medical directors pursuant to contracts that specified numerous job duties and hourly requirements. Its seven rehabilitation and skilled nursing facilities in Miami-Dade County had several medical directors under contract at any given time, paying each several thousand dollars monthly.
The government alleged that these were ghost positions, and that most of the medical directors were required to perform few, if any, of their contracted job duties. They were allegedly paid for their patient referrals to the Hebrew Homes facilities, which increased exponentially once the medical directors were put on the payroll.
The Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by federal health care programs, including Medicare.
As part of the settlement, William Zubkoff agreed to resign as Hebrew Homes’ executive director and to no longer be an employee of the company. Also, as part of the settlement announced today, Hebrew Homes has entered into a five-year corporate integrity agreement with Department of Health and Human Services’ Office of Inspector General, and has agreed to change its policies on hiring and maintaining medical directors.
