By William J. Beerman, Sr
In response to a request for a reply, an Orlando, FL nursing home issued a statement pushing back against a Department of Justice news release.
On January 28, 2019, U.S. Attorney Maria Chapa Lopez announced that Conway Lakes skilled nursing facility, several entities associated with Conway Lakes, and an Orlando-area orthopedic surgeon, Dr. Kenneth Krumins, agreed to pay $1.5 million to resolve allegations that they engaged in a kickback scheme related to the referral of Medicare and TRICARE patients.
The settlements resolve allegations that Conway Lakes, through associates, conspired to pay Dr. Krumins under a sham “medical director” agreement to induce him to illegally refer Medicare and TRICARE patients to Conway Lakes for rehabilitation services that were billed to the federal government, the U.S. Attorney said. Dr. Krumins’ settlement agreement also resolves allegations that he engaged in a similar kickback scheme with a related home health agency, the U.S. Attorney said.
On February 1, Conway Lakes issued a statement saying, “First and foremost, Conway Lakes is a Five-Star, Governor’s Gold Seal recipient, whose quality of care surpasses both state and national averages. “
Conway Lakes pointed out that it had not admitted any wrongdoing, but “determined that it would be less disruptive to its business and its patients to negotiate a settlement with the government.”
The government alleged that financial arrangements violated the physician self-referral law, commonly known as the “Stark Law,” and the Anti-Kickback Statute, giving rise to liability under the False Claims Act. Under two separately executed settlement agreements, Dr. Krumins has agreed to pay $500,000, and Conway Lakes and associates have agreed collectively to pay $1 million to the federal government, the DOJ said.
“Disguising intricate kickback arrangements through directorships and other misrepresented positions corrupts physician decisionmaking and undermines the public’s trust in the healthcare system,” said Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services’ Office of Inspector General.
The allegations resolved by the settlement agreements were originally brought in a lawsuit filed by a former employee of Conway Lakes, under the qui tam, or whistleblower, provisions of the False Claims Act, the government said. The act permits private citizens with knowledge of fraud against the government to bring an action on behalf of the United States and to share in any recovery. The whistleblower will receive $267,000 of the proceeds from the settlements, the government said.
Conway Lakes said the whistleblower is a former employee who was dismissed for failing to show up to work, never reported any of his concerns, nor did he inform a supervisor of any of the claims. Conway Lakes said the whistleblower lodged accusations against multiple individuals “without any evidence.”
The claims settled by the agreement are allegations only, and there has been no determination of liability, the original DOJ news release pointed out.