A Texas-based physician recently entered a settlement to pay nearly half a million dollars for their alleged involvement in a hospice kickback scheme that transpired roughly four years ago.
Dr. John Patterson agreed to pay $486,626 to resolve allegations of kickback payments received from Nursemind Home Care. Patterson is accused of certifying patients for hospice care who did not have a terminal condition and were not eligible to receive these services. The allegations also include receiving kickback payments for hospice patient referrals.
Patterson’s alleged actions caused false claims to be submitted to Medicare, according to a report from the U.S. Justice Department.
“Dr. Patterson falsely certified individuals for hospice services under Medicare when they did not meet eligibility criteria,” Special Agent in Charge John Morales for FBI El Paso said in a statement. “He violated his oath as a physician to fight against health care fraud and waste. We will go after individuals who seek to enrich themselves by jeopardizing the health care of Medicare beneficiaries and defrauding American taxpayers.”
Patterson reportedly received cooperation credit under the terms of the settlement pursuant to the Justice Department’s guidelines for taking voluntary disclosure, cooperation and remediation into account in False Claims Act (FCA) matters. FCA cases often hinge on the question of whether live discharges from hospice care were the result of deliberate fraud or occurred because of the inherent difficulty of predicting a patient’s life expectancy.
Assistant U.S. Attorney Eduardo Castillo negotiated the civil settlement on behalf of the United States.
Patterson has cooperated with the federal investigation, according to the Justice Department. He has agreed to cooperate with an ongoing criminal investigation and to testify truthfully in any resulting criminal prosecutions, among other efforts, the department indicated.
Investigations into the kickback scheme have been ongoing for several years. Nursemind Owner Zenia Chavez and her nephew Rual Alenjandro Fuentes were arrested in 2021 for their involvement in the hospice fraud scheme. The charges included enrolling patients in Nursemind’s hospice program who did not have terminal illnesses or were otherwise ineligible to receive the benefit. Chavez pleaded guilty to one count of conspiracy to commit illegal remunerations regarding a federal health care program.
Assistant U.S. Attorneys Chris Skillern and Debra Kanof represented the United States in the criminal prosecution of Chavez.
