California Docs Charged in $115M 'Cash-for-Patients' Kickback Scheme

Megan Brooks

September 09, 2019

Two home healthcare agencies in California and 28 individuals — including an agency CEO, 13 physicians, five nurses, and a social worker — have been charged for their alleged involvement in a multimillion dollar kickback scheme to trade referrals of Medicare patients for cash and gifts.

According to KNTV in San Francisco, the US attorney said the Medicare reimbursement scheme involved $115 million in tainted claims and $8 million in kickbacks.

The kickbacks were often disguised as payroll, phony medical directorships, entertainment, reimbursements, gifts, or donations, according to the Department of Justice (DOJ).

"This is the largest cash-for-patients scheme ever charged criminally in the Northern District of California," US Attorney David Anderson, said in a news release.

At the center of the scheme are Amity Home Health Care, the largest home health care provider in the San Francisco Bay Area; and Advent Care, Inc, a provider of hospice care.

The DOJ alleges that Amity Home Health Care, under the leadership of CEO Ridhima "Amanda" Singh, paid kickbacks to marketers, doctors, and other medical professionals in return for certification or referral of patients for home health or hospice services. 

Singh and her employees allegedly compensated these professionals in cash for each patient referral and for making introductions to physicians, case managers, or other healthcare professionals who could refer patients.

Singh allegedly instructed marketers to take clients out to elaborate meals, sporting events, and purchase gifts for individuals willing to provide Amity with patients, mainly Medicare patients.

When patient referrals were slow, Singh allegedly directed the marketer to incentivize clients with gifts in an effort to induce them to refer more patients to Amity, the DOJ said.

In addition, several of the defendants allegedly received bribes in exchange for making referrals to Amity and Advent and other home health agencies so that the companies could bill for services, the DOJ said.

Years in Prison Possible

All of the defendants were recorded by law enforcement officers either offering, accepting, or approving illegal payments for patient referrals.

"The transition to a home health agency should be based on medical and personal needs — not cash payments or thinly disguised referral bribes as alleged in these cases," Steven Ryan, special agent in charge for the Office of Inspector General of the US Department of Health and Human Services (HHS-OIG), said in the release. "We will continue working with law enforcement partners to guard these vital government health programs, as patients and taxpayers deserve better."

Each defendant is charged with illegally influencing patient referrals for federally funded health care through payments, the DOJ said. In addition, Singh is charged with lying to investigators and tampering with witnesses.

If convicted, the defendants face up to 10 years in prison and a maximum fine of $500,000. In addition, Singh faces a maximum statutory penalty of 5 years in prison, a $250,000 fine for lying to investigators and a maximum statutory penalty of 20 years and a $250,000 fine for witness tampering. Amity Home Health Care and Advent Care are subject to a $1 million fine for each violation.

The prosecution is being handled by the Office of the US attorney, Northern District of California's new Corporate Fraud Strike Force, and is the result of an investigation by the FBI and HHS-OIG.

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