Compliance News Roundup: 30 Defendants Charged in Patient-for-Cash Kickback Scheme in S.F.

Compliance News Roundup: 30 Defendants Charged in Patient-for-Cash Kickback Scheme in S.F.

Posted by Healthicity
Nov 6, 2019 10:02:02 AM

1. Texas Doctor Pays $2 Million to Resolve False Claims Allegations - Dr. Augusto Castrillon, a Texas family practitioner has agreed to pay the United States $2.1 Million in order to resolve allegations he fraudulently submitted claims to Medicare for medically unnecessary diagnostic tests. “This settlement reflects our continued resolve to protect the Medicare program from exploitation,” said U.S. Attorney Ryan K. Patrick.

Dr. Augusto Castrillon, a family physician who, until recently, operated the Castrillon Family Clinic in Mission, Texas appeared to be ordering an excessive number of diagnostic tests. Claims data indicated these tests were ordered for patients on a recurring basis.

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2. Bay Area’s Largest Home Health Agency Charged In Kickback Scheme - Amity Home Health, the largest home health provider in the San Francisco Bay Area, and Advent Care, Inc., a provider of hospice care, are at the center of an alleged multi-million dollar scheme to receive referrals for Medicare patients. Federal complaints have been filed against 30 defendants charged in a patients-for-cash kickback scheme The complaints, unsealed this morning, describe a wide-ranging patients-for-kickback scheme. All the defendants participated in the scheme whereby Amity, under the leadership of Chief Executive Officer Ridhima “Amanda” Singh, paid kickbacks to marketers, doctors, and other medical professionals in exchange for the certification or referral of patients for home health or hospice services.

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3. Deeper Than the Headlines: Nursing Home Health and Safety Complaints - The OIG recently released some data related to trends in nursing home complaints. CMS relies upon each State's survey agency to respond to health and safety concerns raised by residents, their families, and nursing home staff. State agencies must investigate the most serious complaints on-site within certain timeframes. The OIG feels the nursing home complaint process is a critical safeguard to protect vulnerable nursing home residents.

However, a previous OIG report found that a few States fell short in the timely investigation of the most serious nursing home complaints.

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