Discharge Planners Targeted for Home Health Fraud

Federal Criminal Complaints have been filed against thirty defendants in the San Francisco area who are charged in a “patients-for-cash” kickback scheme. The complaints center on Amity Home Health Care, the largest home health care provider in the Bay Area, and Advent Care, Inc., a hospice. Under the leadership of Ridhima “Amanda” Singh, Chief Executive Officer, the federal government claims that Amity and Advent paid kickbacks to discharge planners/case managers at hospitals and social workers at skilled nursing facilities (SNFs), among others, in exchange for referrals.

The Criminal Complaints says that discharge planners/case managers in hospitals and SNFs received the following in exchange of referrals of home health and hospice patients:

• Cash periodically delivered in envelopes

• Gift cards ranging in value from $2,000 to $5,000

• Handbags from Gucci, Louis Vuitton and Nordstrom

• All expenses paid trips to Napa, California

These alleged payments and gifts clearly violate the federal anti-kickback statute. This statute generally prohibits anyone from either offering to give to actually giving anything to anyone in order to induce referrals.

If convicted, all parties involved may be subject to imprisonment for up to ten years and fines of $500,000. So, the stakes are high!

Anecdotally, for years the home care industry has been rife with rumors that discharge planners/case managers in hospitals and SNFs were accepting kickbacks in exchange for referrals. For perhaps the first time, fraud enforcers are targeting discharge planners/case managers for enforcement action. It may be the first time, but it surely will not be the last time.

This makes it even clearer that marketers for home health companies and discharge planners/case managers must just say, “NO!” The “jig is up,” as they say. Discharge planners/case managers, you have been discovered! Enforcers now know, if they didn’t before, that there are discharge planners/case managers who accept payments and other items in exchange for referrals. Case managers/discharge planners and marketers can certainly expect more enforcement actions against them in the near future.

Elizabeth E. Hogue, Esq.

Office: 877-871-4062

Fax: 877-871-9739

E-mail: ElizabethHogue@ElizabethHogue.net

Twitter: @HogueHomecare