Skilled Nursing Facility Company Agrees to Pay More Than $3 Million to Resolve Kickback Allegations
HOUSTON – Regent Management Services L.P. 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, announced U.S. Attorney Kenneth Magidson and Gregory Demske, Chief Counsel to the Inspector General of the U.S. Department of Health and Human Services-Office of Inspector General (HHS-OIG) and Special Agent in Charge CJ Porter, of HHS-OIG, Office of Investigations, Dallas Regional Office.
Regent Management Services L.P. is headquartered in Galveston and manages 12 separately owned and operated nursing facilities including 11 in seven Texas cities.
The settlement is believed to be the first in the nation to hold accountable medical institutions (hospitals and skilled nursing facilities) rather than ambulance companies for these kind of ambulance “swapping” arrangements.
“This resolution is part of the government’s emphasis on combating health care fraud throughout the district and is an example of our determination to hold those accountable for their actions,” said Magidson. “Any type of improper behavior or arrangement in the industry is a serious allegation that we will not take lightly and we will pursue in order to protect the integrity of the health care system.”
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.
“This settlement sends a message to the health care industry that both sides of a swapping arrangement can be held responsible for their improper actions, not just the entity that actually bills Medicare or Medicaid for the services,” said Demske. “Any company or individual considering entering such schemes should understand that their actions may have serious legal and financial consequences.”
Medicaid is funded jointly by the states and the federal government. The state of Texas paid for some of the Medicaid claims at issue and will receive approximately $533,000 of the settlement amount.
In connection with the settlement, Regent has also entered into a corporate integrity agreement (CIA) with HHS-OIG. The corporate integrity agreement obligates Regent to undertake substantial internal compliance reforms for the next five years.
“Swapping arrangements continue to be an area of concern throughout the ambulance industry,” said Porter. “Such improper arrangements among providers 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.”
Today’s announcement also marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.
The settlement was the result of a coordinated effort among the U.S. Attorney’s Office, HHS-OIG, HHS-OIG (Office of Counsel to the Inspector General) and the Texas Attorney General’s Office. Assistant U.S. Attorney Kenneth Shaitelman handled the case on behalf of the U.S. Attorney’s Office for the Southern District of Texas.
The claims resolved by this settlement are allegations only, and there has been no determination of liability.