The owner of an Illinois-based home health care company admitted in federal court last week that he paid illegal kickbacks to 20 medical directors to acquire referrals of elderly Medicare patients.
Between December 2006 and September 2014, Romy Macasaet Jr., owner of Home Bound Healthcare Inc. of Lemont, Ill., paid more than $789,000 in bribes to the medical directors who sent Medicare patients his way in exchange for the money.
The illegal kickbacks resulted in Mr. Macasaet receiving Medicare reimbursements worth millions of dollars, according to U.S. Attorney for the Northern District of Illinois Zachary Fardon. Mr. Macasaet used various agreements with the medical directors to conceal the bribes, federal prosecutors alleged.
Macasaet, 47, pleaded guilty to one count of violating the Anti-Kickback Statute. The conviction is punishable by up to five years in prison. He will be sentenced in February of next year.
Additionally, Mr. Macasaet and Home Bound agreed to pay the U.S. $6.8 million to resolve the civil false claims and anti-kickback allegations.
As part of the civil settlement, Mr. Macasaet agreed to immediately resign his employment with Home Bound and refrain from seeking future employment with the company. He also agreed to divest his ownership interest in Home Bound within 120 days.
At the same time, Home Bound and the Health and Human Services Department entered into a corporate integrity agreement to ensure the company’s compliance with the rules of Medicare, Medicaid, and other federal health care programs. The integrity agreement requires Home Bound to develop and implement policies, procedures, and practices designed to ensure compliance.
The False Claims Act (FCA) is one of the U.S. government’s strongest weapons in the fight against taxpayer fraud. Last year was the fourth consecutive year the FCA has recovered more than $3.5 billion in fraud settlements, judgments, fines, restitution, and forfeiture for the U.S. government and taxpayers. Nearly $2 billion of recoveries in 2015 stemmed from health care fraud.
While the case against Mr. Macasaet and Home Bound was initiated by government authorities, most false claims actions are brought by whistleblowers under the Act’s qui tam provisions, which authorize private individuals to sue on the government’s behalf, and receive a percentage of any money recovered as a reward for their efforts.