A Florida home health care company has agreed to pay the U.S. government $1.1 million to resolve a whistleblower lawsuit brought against it by a former employee, who alleged the company entered into improper financial arrangements with doctors and violated federal anti-kickback laws.
The complaint, filed by whistleblower Gregory Simony in a U.S. court in Tampa, Fla., alleged that Recovery Home Care Inc., Recovery Home Care Services Inc. (collectively Recovery Home Care), and National Home Care Holdings LLC paid dozens of physicians thousands of dollars each month to perform patient chart reviews that involved little or no work.
West Palm Beach, Fla.-based Recovery Home Care over-compensated doctors for this work, the lawsuit alleged, because the pay was actually an incentive used to induce doctors for patient referrals. Paying doctors for patient referrals violates the Anti-Kickback Statute and the Stark Law, which are intended to ensure that a doctor’s judgment about patient care is not compromised by improper financial incentives.
The lawsuit also alleges that the kickback scheme led to the submission of false claims to Medicare and other federal health care programs.
In his whistleblower lawsuit, Mr. Simony alleged that Recovery Home Care engaged in this kickback scheme from 2009 through 2012, leading government health care programs to pay for patient care that was clouded by improper financial incentives.
“Inducements of this kind are designed to improperly influence a physician’s independent medical judgment,” said U.S. Attorney A. Lee Bentley III of the Middle District of Florida, who helped prosecute the case. “This lawsuit and today’s settlement attests to our office’s on-going commitment to safeguard federal health care program beneficiaries from the effects of such illegal conduct.”
Mr. Simony filed his lawsuit under the qui tam provisions of the False Claims Act – a federal law that provides incentives and protections for whistleblowers who report fraud against federal taxpayer-funded agencies and programs.
Employees and contractors who witness fraud and other misconduct must assess the risks and rewards of becoming a whistleblower, a process that usually leads to the questions “how much can a whistleblower make?”
Under the terms of the False Claims Act, which authorizes privte individuals to sue on behalf of the government, whistleblowers are awarded up to 30 percent of the total amount the U.S. is able to recover.
In exchange for his role in exposing Recovery Home Care’s kickback scheme, Mr. Simony will receive 18 percent ($198,000) of the recovered funds.