Docs, Wives to Pay $1 Million Over Home Health Kickback Claims
Two South Florida physicians and their wives have agreed to pay $1.3 million to settle charges that they accepted kickbacks from a home health agency, the Department of Justice announced Monday. The home health provider had tried to disguise the payments by saying they were for marketing services providing by the physicians’ wives, according to the charges.
Under the settlement, Alan Buhler, M.D. and his wife Lynn Buhler will pay $1.047 million to the U.S. government, and Craig Prokos, M.D. and his wife Cynthia Prokos will pay $90,000.
Buhler, who practices in Pleasanton, Fla. and Prokos, who practices in Jupiter, Fla., allegedly violated the False Claims Act when their wives accepted sham marketer salaries in exchange for referrals to A Plus Home Health Care, Inc.
Federal investigators allege that beginning in 2006, A Plus and its owner, Tracy Nemerofsky, engaged in a scheme to increase Medicare referrals in the heavily saturated home health care market of South Florida.
Specifically, investigators alleged that A Plus paid spouses of referring physicians for “sham marketing positions” in order to induce patient referrals. Lynn Butler and Cynthia Prokos were among the spouses allegedly paid by the home health company.
“The United States alleged that the spouses were required to perform few, if any, of the job duties they were allegedly hired for and instead, the spouses’ salaries were intended as an inducement for the husband physicians to refer their Medicare patients to A Plus,” the Justice Department stated in a release.
The federal authorities also alleged that Alan Buhler received medical director payments as part of A Plus’s scheme to obtain his referrals and he attempted to hide those payments from the government.
There was no determination of liability in this case, and the settlement resolves the charges. However, the deal is an example of the Justice Department’s efforts to hold accountable those involved in kickback schemes, said U.S. Attorney Wilfredo A. Ferrer of the Southern District of Florida.
“Health care providers should generate business by offering their patients superior care,” Ferrer said in a written statement. “Financial relationships that put profits over patients undermine the quality and care given to patients and ultimately, the integrity of our public health care program upon which millions of Americans depend.”
The settlements mark another achievement for the Health Care Fraud Prevention and Enforcement Action Team — or colloquially, “HEAT” — initiative announced in May 2009 by the Attorney General and the Secretary of Health and Human Services.
“Physicians who engage in such in-your-face kickback schemes to refer Medicare patients to certain home health companies in exchange for money will be held accountable for their behavior,” said Special Agent in Charge Derrick Jackson of the U.S. Department of Health and Human Services Office of Inspector General.
Previously, the United States settled with A Plus, owner Tracy Nemerofsky, and five other couples that allegedly accepted payments from A Plus.
Written by Jason Oliva