by Ben Vernia | June 21st, 2023
On June 21, the Department of Justice announced that a skilled nursing facility based in Riverside, California, has agreed to pay $3.825 million to settle False Claims Act charges, originally brought by a whistleblower, that the facility paid kickbacks to physicians to refer patients. According to DOJ’s press release:
Alta Vista Healthcare & Wellness Centre, LLC (Alta Vista), a skilled nursing facility in Riverside, California, and its management company, Rockport Healthcare Services (Rockport), have agreed to pay the United States and California a total of $3.825 million to resolve allegations that they submitted and caused the submission of false claims to Medicare and Medicaid by paying kickbacks to physicians to induce patient referrals. The settlement amount was negotiated based on Alta Vista’s and Rockport’s lack of ability to pay.
The Anti‑Kickback Statute prohibits offering or paying remuneration to induce the referral of items or services covered by Medicare, Medicaid, and other federally funded programs. It is intended to ensure that medical decision-making is not compromised by improper financial incentives and is instead based on the best interests of the patient.
From 2009 through 2019, Alta Vista, under the direction and control of Rockport, gave certain physicians extravagant gifts, including expensive dinners for the physicians and their spouses, golf trips, limousine rides, massages, e-reader tablets, and gift cards worth up to $1,000. Separately, Alta Vista paid these physicians monthly stipends of $2,500 to $4,000, purportedly for their services as medical directors. At least one purpose of these gifts and payments was to induce these physicians to refer patients to Alta Vista.
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The defendants’ conduct allegedly resulted in false claims to Medicare and California’s Medicaid programs, the latter of which is jointly funded by the federal government and California. Under the settlement, they will pay $3,228,300 to the United States and $596,700 to California.
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The government announced that the company has agreed to a five-year Corporate Integrity Agreement, and that the whistleblower, a former accounting employee, will receive $581,094 of the federal portion of the recovery (an 18% relator’s share).
