2 health care providers, dozens of people charged in alleged $115M Medicare kickback scheme
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Two health care providers and 28 people – including one of the providers' CEO, 13 doctors, five nurses and a social worker – were charged with involvement in a $115 million Medicare kickback scheme in California, the Justice Department announced Thursday.
Amity Home Health Care was said to have bribed more than two dozen defendants with kickbacks disguised as payroll, phony medical directorships, “reimbursements,” “entertainment” or “gifts” so they would make referrals to Amity and hospice provider Advent Care, which in turn could bill for those services, prosecutors said. Amity Home Health Care is the largest home health care provider in the San Francisco Bay area, the DOJ said.
“The complaints allege a scheme for doctors, nurses and other medical care professionals to trade patients for cash,” U.S. Attorney David Anderson said. “This is the largest cash-for-patients scheme ever charged criminally in the Northern District of California.”
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Prosecutors said Amity CEO Ridhima “Amanda” Singh allegedly bribed “marketers” with cash and gifts and instructed them "to take clients out to elaborate meals, sporting events and purchase gifts for individuals willing to provide Amity with patients.” Those were mainly patients on Medicare, the federal health program for people 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 said.
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Every single defendant was recorded as offering, accepting or approving the kickbacks for referrals, according 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,” said FBI Special Agent in Charge Steven Ryan. “We will continue working with law enforcement partners to guard these vital government health programs, as patients and taxpayers deserve better.”
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Each of the defendants was charged with illegally influencing patient referrals for federally funded health care through payments, the DOJ said. In addition, Singh was charged with lying to investigators and tampering with witnesses.
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If found guilty, the defendants will face up to 10 years in prison and a maximum $500,000 fine. Singh could also face a statutory penalty of up to five years in prison and a $250,000 fine for lying to investigators, as well as a statutory penalty of up to 20 years in prison and another $250,000 fine for tampering with witnesses.
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For each violation, the corporations would be subject to a $1 million fine.