Consumer Fraud

U.S. takes over whistleblower lawsuit against Florida home health care company

osha whistle U.S. takes over whistleblower lawsuit against Florida home health care companyThe U.S. Justice Department has intervened in a whistleblower lawsuit against A Plus Home Health Care, Inc. of Fort Lauderdale, Fla., and its owner Tracy Nemerofsky. The lawsuit accuses the company and its owner of defrauding Medicare by creating fake positions for the spouses of affiliated physicians as a way of providing kickbacks in exchange for Medicare patient referrals.

According to the U.S. attorney’s office in Miami, the South Florida home health care provider started paying the wives of seven or more doctors and the boyfriend of another physician for performing little or no work. As a result, the company’s Medicare income grew sixfold from $1.1 million in 2005 before the scheme began, to $6.6 million in 2011.

“Kickback schemes subvert the home health care market place and undermine the integrity of consumer choice,” said Stuart F. Delery, Acting Assistant Attorney General for the DOJ’s Civil Division. “We will continue to hold accountable those who abuse our public health care programs at the expense of patients and taxpayers.”

The lawsuit was filed by William Guthrie, a former A Plus Home Health Care director of development, under the qui tam “whistleblower” provisions of the False Claims Act (FCA), which enable individuals to to sue on behalf of the U.S. government and receive a share of the recovery. The act also authorizes the government to intervene in a whistleblower lawsuit and thus assume primary responsibility for litigating, as it did with the case involving A Plus.

The lawsuit alleges that the company hired the spouses and boyfriend to perform marketing duties for A Plus, but required them to do few, if any, of the duties. Ms. Nenerofsky created “sham personnel files,” the DOJ alleges, as a way to cover up the fraud by making the spouses and boyfriend appear on record as legitimate employees. The fake files included lists of job duties that the spouse and boyfriend never performed and performance reviews of job tasks they never completed.

The lawsuit also alleges that the spouses’ and boyfriend’s salaries were both inducement and reward for the physicians’ referrals of Medicare patients to A Plus Home Health Care in the heavily saturated home health care market in South Florida.

“We will not relent in our efforts to combat fraudulent kickback schemes, such as the no-show jobs scheme used in this case, and return dollars to the Medicare program,” said Wifredo A. Ferrer, U.S. Attorney for the Southern District of Florida. “These schemes are classic examples of the fraud and abuse that plague and threaten the financial stability of Medicare, which provides much needed services to the sick and elderly.”

Source:

U.S. Department of Justice