Three nurses have been indicted in Chicago for participating in a conspiracy that involved paying kickbacks in exchange for referring Medicare patients to their home health care agency. They face up to five years in prison and a fine of $250,000 on each count in the indictment.
The alleged conspiracy involved paying kickbacks to other nurses and home health care workers who referred patients to the agency, re-certified patients as homebound, or caused patients to begin new 60-day care cycles of home health care with the agency. As a result of the conspiracy, the government alleges, the home health care agency was able to bill Medicare for more than $5 million in reimbursement.
The federal anti-kickback statute prohibits giving, accepting, asking for, or arranging anything of value for the purpose of inducing or rewarding another party for referrals of services paid for by a federal government health care program.
The statute is very broad. In addition to referrals of patients, it also covers paying or receiving anything of value in return for purchasing, ordering, or leasing any equipment or services paid for by a federal health care program.
According to the indictment, the kickback amounts in this case ranged from $400 to $700 for each new care cycle and $100 to $300 for each re-certification. The government alleges that the defendants even prepared a memo advising other nurses and home health care workers exactly how much they would be paid for helping the agency get or retain Medicare patients.
By charging the nurses with a conspiracy, the government is casting a very wide net. Even if a nurse did not know about all the kickbacks, if she was aware that some kickbacks were being made and participated in any of them, she could be charged with participating in the conspiracy involving all the kickbacks.
If you are aware that kickbacks are being offered to get or retain Medicare or Medicaid patients, then you should consult with an experienced lawyer immediately to protect yourself. To schedule a free and confidential consultation by telephone or in person, call my office today at (212) 601-2728 or click here to communicate with me via email.
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