The U.S. Attorney’s Office for the Southern District of Texas announced on November 30, 2015 that Texas-based Regent Management Services L.P. (“Regent”), which manages 12 separately owned and operated nursing facilities, including 11 in seven Texas cities, has agreed to pay approximately $3.199 million to settle allegations that it received kickbacks from various ambulance companies in exchange for rights to Regent’s more lucrative Medicare and Medicaid transport referrals.
The settlement resolves allegations that patients at Regent facilities received free or heavily discounted ambulance transports from various ambulance companies in exchange for Regent’s referral of other lucrative Medicare and Medicaid business to those same companies, for which Regent would have been financially responsible at significantly higher rates but for the kickback scheme.
Not only are such alleged kickback schemes illegal because they cost federal health care programs many millions of dollars in health care funding that would otherwise be spent on the legitimate health care needs of the most needy in our communities, such kickback schemes also “have the potential to negatively affect patient care and need to be aggressively pursued in order to protect the integrity of the federal health care programs and their beneficiaries,” according to the Special Agent in Charge, HHS-OIG, Office of Investigations, Dallas Regional Office.
The news release issued by the U.S. Attorney’s Office, Southern District of Texas, regarding the Regent settlement states: “the Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by federal health care programs, including Medicare and Medicaid. The settlement announced today resolves allegations that patients at Regent facilities received free or heavily discounted ambulance transports from various ambulance companies in exchange for Regent’s referral of other lucrative Medicare and Medicaid business to those same companies. If not for this kickback arrangement, Regent would have been financially responsible for the patient transports at significantly higher rates.”
The Regent settlement is believed to be the first in the U.S. to hold accountable medical institutions, such as hospitals and skilled nursing facilities, rather than ambulance companies, for ambulance “swapping” arrangements.
The U.S. Attorney’s Office’s news release cautions that the claims resolved by the Regent settlement are allegations only and that there has been no determination of liability.
If you have knowledge regarding false claims having been submitted to Medicare, Medicaid, other federal health care programs, or to other federal agencies/programs, and your information is not publically known and no action has been taken by the government with regard to recovering the false claims, you should promptly find a False Claims Act attorney (also known as qui tam attorneys) in your U.S. state who may investigate the basis of your False Claims Act allegations and who may assist you in bringing a qui tam lawsuit on behalf of the United States, if appropriate, for which you may be entitled to receive a portion of the recovery received by the U.S. government.
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