A home health care agency based in Kansas City, Kansas, and its owner have agreed to pay $1.8 million to resolve allegations that they violated the False Claims Act.
Reginald King, owner and operator of Best Choice Home Health Care Agency Inc., was alleged to have had a part in paying kickbacks for referrals of Medicaid-covered patients for home and community-based health care services provided by the company, according to the Department of Justice.
Best Choice provides personal care services, homemaker services, respite care services, night support and attendant care to patients in their homes in Kansas City.
The DOJ alleges that King, on behalf of Best Choice, arranged kickbacks with Christopher Thomas, who transported patients from their homes to healthcare facilities in Kansas City.
From July 1, 2010 through Dec. 31, 2014, King submitted claims for home and community-based healthcare services that resulted from the referrals to Medicaid, the DOJ said. Thomas was paid $58,000 in kickbacks for new patients referred to Best Choice during that time period. Under the alleged arrangement, kickbacks were based on each hour of service that Best Choice billed Medicaid.
“The department will continue to hold accountable entities and individuals that engage in illegal kickback schemes for the referral of patients,” Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division, said in a press release. “It is critically important that we protect the integrity of government health care programs by ensuring that services are provided based on clinical considerations rather than the financial interest of those who refer patients for care.”
Of the $1.8 million that King and Best Choice will pay, the United States will receive $1,011,780 and the state of Kansas will receive $788,220.
The allegations that were brought came under the whistleblower provision of the False Claims Act by Thomas. The False Claims Act permits private parties to sue on behalf of the United States for false claims for government funds and receive a share of any recovery. In this case, the share will be $43,178, minus the amount Thomas received in kickbacks during the scheme.
The False Claims Act has been a powerful tool in combating financial fraud. Since January 2009, the Justice Department has recovered more than $31.6 billion through False Claims Act cases, and more than $19.2 billion of that has been from cases of fraud against federal health care programs.
The claims resolved by the settlement in this case however are only allegations. There has been no determination of liability, the DOJ said.
Written by Alana Stramowski