It is generally illegal to get benefits in exchange for referring patients to health care providers. A registered nurse care coordinator is experiencing just how serious the government is when it comes to allegations of health care fraud.
Allegations of payouts in exchange for patient referrals
The accused was employed within a hospital to help patients find post-acute care-providers. These includes home health care providers and hospice facilities. According to the government, the accused used this position to help a fraudulent operation gain money from Medicare. And the sum is no small figure. The government has accused the group of getting almost $31 million in payment from Medicare beneficiaries using fraudulent referrals leading to $250,000 in illegal kickbacks. The allegations stem from events from 2015 through 2018.
Potential penalties are harsh
The allegations are not yet substantiated. However, they have a negative impact on the accused’s personal and professional reputation. The facility that employed the registered nurse care coordinator put him on leave in response to these allegations. He could face termination of his position as well as criminal charges. Termination based on these allegations may make it difficult for the accused to find future employment.
A criminal conviction is also possible. The accused is currently charged with conspiracy to pay and receive health care kickbacks and receipt of health care kickbacks. If convicted, he faces up to 10 years imprisonment and a $250,000 fine. We will watch this case and provide updates as they become available.
The case provides an example of the serious impact allegations of wrongdoing within the health care profession. It is important for those who are in this field to take such allegations seriously. An attorney experienced in home health agency legal issues can review the allegations and discuss your options.