A Plus Home Health Care Allegedly Participated in Medicare Overcharging Scheme
August 16, 2013 — Medicare fraud robs taxpayers and preys on elderly community members. Tips from conscientious informants can assist federal authorities in combating Medicare and Medicaid fraud. The False Claims Act’s qui tam provisions allow health care insiders to file suit on the government’s behalf and to collect a portion of any judgment or settlement.
DOJ Intervenes in Medicare Fraud Qui Tam Lawsuit
The Department of Justice (DOJ) has announced its intervention in a whistleblower case against A Plus Home Health Care (A Plus), a Florida home health care company, alleging that the company hired physician spouses in a scheme to bolster business and to overcharge Medicare. The False Claims Act lawsuit was filed by William Guthrie, a former A Plus director of development, against A Plus and its owner, Tracy Nemerofsky, for overbilling Medicare in violation of the False Claims Act. A Plus offers skilled nursing, physical therapy and other home health services to Medicare patients in both Broward and Palm Beach Counties in Florida.
Nemerofsky began the A Plus home health care business in 2003 in the south Florida area. Shortly after opening the business, Nemerofsky applied to Medicare to become certified. Competition between home health providers in south Florida was strong at the time. Beginning in 2006, Nemerofsky started hiring physicians’ spouses or companions to market A Plus home health care services to physicians who would in turn refer patients to A Plus. The true purpose of hiring the spouses, according to the DOJ, was to induce physicians to refer Medicare patients to their spouses’ employer. The DOJ alleged that at least seven physicians’ spouses and one boyfriend were hired to market the company, but that there were few duties and little oversight.
In the year before hiring the physicians’ spouses as marketing tools, A Plus was allegedly paid $1.1 million by Medicare. By 2011, when the company had retained the physicians’ spouses and boyfriend, Medicare payments to A Plus had grown to $6.6 million.
The DOJ has announced that it has settled with two of the physician-and-spouse referring couples on charges related to the Medicare billing scheme.
Insiders Rely on False Claims Act to Stop Medicare Fraud
Health care insiders play a crucial role in the fight against Medicare fraud. Before any insider decides to collaborate with the government, however, it is important to become familiar with the False Claims Act and the rights it provides. The whistleblower lawyers at Waters & Kraus offer the guidance and protection you need. Contact us by email or call our False Claims Act attorneys at 855.784.0268 to find out more about our Medicare fraud practice and how we can help you.