Hospice, home health agency and owners pay over $1.8M to resolve claims concerning physician payments
McALLEN, TS (STL.News) The founders of an Edinburg hospice and related home health agency have paid to resolve allegations they submitted claims to Medicare that resulted from unlawful referrals, announced U.S. Attorney Ryan K. Patrick.
Onder Ari, 49, Edinburg, and Sedat Necipoglu, 48, McAllen, founded Allstate Hospice LLC and Verge Home Care LLC. They and their companies have now paid $1,847,279.36 following an investigation into improper payments to physicians for referrals.
The investigation began in 2016 and revealed Ari and Necipoglu offered compensation to physicians who were responsible for a significant majority of their patient referrals. Specifically, they provided physicians with monthly payments pursuant to medical directorship agreements with Allstate and Verge. Those payments were in excess of fair market value for the services the physicians actually provided.
Ari and Necipoglu also sold interests in Allstate to five different physicians which ultimately netted them substantial quarterly dividends. They also provided physicians other gifts and benefits, such as travel and tickets to sporting events.
The Physician Self?Referral Law, commonly known as the Stark Law, prohibits specified entities from billing Medicare for certain services referred by physicians with whom the entity has a financial relationship, unless that relationship satisfies one of the law’s statutory or regulatory exceptions. The Anti?Kickback Statute prohibits offering or paying remuneration to induce the referral of items or services Medicare, Medicaid and other federally-funded programs cover. Both the Stark Law and the Anti-Kickback Statute are intended to ensure the best interests of the patient and that improper financial incentives do not compromise medical decision-making.
“The FBI is committed, along with its partners, to taking action to eliminate improper relationships and inducements that can corrupt the integrity of physician decision-making and increase health care costs,” said Special Agent in Charge Christopher Combs, FBI San Antonio Division. “Along with criminal prosecution, the FBI will also pursue administrative and civil remedies with the U.S. Attorney’s Office (USAO) and our partner investigative agencies, to prevent, deter and recover government losses sustained by fraud, waste and abuse.”
“Paying physicians to steer patients to one provider over another unacceptably subverts patient choice,” said Special Agent in Charge Miranda Bennett of the Department of Health and Human Services – Office of Inspector General (DHHS-OIG). “We will continue to work with our law enforcement partners to investigate improper payments to physicians to protect patients and the integrity of the programs from unscrupulous acts.”
The FBI and DHHS-OIG conducted the investigation along with the USAO. Assistant U.S. Attorney Brad Gray handled the matter.
The claims resolved by this agreement are allegations only, and there has been no determination of liability.