Largest SNF settlement payment: $17M
A Florida skilled nursing facility chain will pay $17 million to settle Medicare fraud allegations, the largest amount ever paid, according to the Department of Justice.
Miami-based Plaza Health Network, formerly known as Hebrew Homes Health Network, was alleged to have violated the Anti-Kickback Statute when it paid physicians to pose as medical directors in exchange for Medicare patient referrals to its facilities.
Former Plaza Health CFO Stephen Beaujon filed a whistleblower lawsuit in 2012, which also alleged the company created false records to cover up almost $130 million in improper Medicare and Medicaid payments between 2008 and 2011.
William Zubkoff, who left Plaza Health Network in March, ran the scheme from 2006 to 2013, according to prosecutors. The federal government joined Beaujon's lawsuit, which claimed other Plaza Health executives and the board of directors knew of the fraud. The company has eight nursing and rehabilitation centers.
“Illegal inducements paid to physicians in exchange for patient referrals will not be tolerated,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer said. “Medicare funds should be used to provide care for our senior citizens.”
Beaujon will receive $4.25 million of the settlement. He also alleged the company inflated the value of Plaza's real estate assets to get low-interest government loans, according to the Miami Herald. Beaujon was a “disgruntled employee,” according to Plaza's board of directors, the paper reported.
The chain will be under a five-year corporate integrity agreement, and will change its policies for hiring.