A home health care agency in Florida is facing a whistleblower lawsuit by the United States government alleging health care fraud.

Doctor’s Choice Home Care Inc. and its partial owners Timothy Beach and Stuart Christensen allegedly paid kickbacks to referring physicians and disguised these as payments to “medical directors” and as extra payments to employees.

The home health agency based in Sarasota, Fla. allegedly paid kickbacks in the form of sham medical directorships to three doctors to refer their patients to Doctor’s Choice Home Care. The trio of physicians purportedly did very little, if anything, in the form of real work for Doctor’s Choice. By allegedly paying the doctors as medical directors when all they did was refer patients to the home care agency, the agency violated the Anti-Kickback Statute and the Stark Law.

Beach and Christensen allegedly knew about the scheme, which also included paying some of their own employees for a high volume of referrals received by their physician spouses, which is a violation of the Stark Law.

“Healthcare providers must make recommendations about their patients’ health without respect to their own financial interests,” said Assistant Attorney General Jody Hunt for the Department of Justice’s Civil Division. “We will continue to do our part to protect federal health care program beneficiaries and the American taxpayers from the corrupting influence of kickbacks designed to undermine the impartiality and integrity of physician decision making.”

According to the Doctor’s Choice website, the company operates out of 14 different locations, mainly along the western Florida coast. The company claims to be committed to “core values” including courage, compassion, commitment, caring and community in their effort to provide home health care needs to people who need assistance, but wish to remain living in their own homes.

Stopping Health Care Fraud

Federal and state governments have laws in place to encourage employees to report unscrupulous, fraudulent activity at their place of work.

The whistleblower lawsuit against Doctor’s Choice was filed under the “qui tam” or whistleblower provisions in the False Claims Act. Private parties are allowed to file a lawsuit on behalf of the U.S. government for false claims and receive a portion of any recovery. The U.S. government is allowed to intervene by taking over the responsibility to litigate the case, which it chose to do in this instance.

If found liable, Doctor’s Choice, Beach, and Christensen could be subject to paying three times the government’s losses, in addition to penalties that may apply.

The Anti-Kickback Statute makes it wrong for anyone to pay or reward someone for referrals for services paid through federal healthcare programs. The Stark Law prohibits medical providers and home health agencies from submitting claims to Medicare for services received by patients who were referred by a doctor who benefited from an illegal financial arrangement.

According to federal statistics, money recovered due to healthcare whistleblower cases for Medicare and Medicaid was more than $3.7 billion in the fiscal year ending Sept. 30, 2017. Since Congress profoundly strengthened the civil False Claims Act in 1986, the government has recovered more than $56 billion, most of which involved health care fraud, according to the Justice Department’s Civil Division.

This article is not legal advice. It is presented
for informational purposes only.