A Pennsylvania-based long-term care and rehabilitation hospital operator has agreed to pay over $13 million in fines to settle charges that it paid to obtain referrals for services and items covered by Medicare and Medicaid.
Federal investigators say Post Acute Medical, LLC made a habit of paying physicians to refer procedures covered by Medicare and Medicaid since the company’s founding in 2006. They say the firm violated both the Anti-Kickback Statute and the Physician Self-Referral Law, commonly known as the Stark Law, by entering into agreements with physicians that would place them as administrators for the firm in order to encourage them to refer patients to its hospitals.
Additionally, investigators said Post Acute Medical entered into arrangements with unaffiliated health care providers like home health care companies that consisted of an understanding that each party would refer patients to the other, which is a violation of the Anti-Kickback Statute.
Federal investigators allege that the firm submitted false claims to programs administered by both state and federal governments. In order to settle the claims, Post Acute Medical agreed to pay approximately $13 million to the federal government, $114,000 to the state of Texas, and $22,000 to the state of Louisiana. In addition, Post Acute Medical has agreed to enter into a five-year Corporate Integrity Agreement with the Department of Health and Human Services Office of Inspector General that involves independent review of claims submitted to state- and federally-funded health insurance programs.
The complaint against Post Acute Medical was brought under the qui tam, or whistleblower, provisions of the False Claims Act (a/k/a, the Lincoln Law). Federal investigators examine the claims made in such actions and take on the suit if investigators determine the complaints have merit.
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