One of Illinois’ largest home care agencies found itself dealing with controversy in recent years when accusations that the owner had been involved in an elaborate scam, paying kickbacks to doctors who referred patients to his agency to provide some type of care that Medicaid reimbursed them for.
The prosecutors in the case alleges that Romy Macasaet, Jr. paid almost $790,000 in kickbacks, or bribes, to more than 20 doctors between 2006 and 2012. Mr. Macasaet, Jr. admitted in court to the scheme and also agreed to pay the government back $6.8 million for Medicare reimbursements received through this fraud.
As part of the plea agreement, Romy Macasaet, Jr. also stipulated to the requirement that he divest his ownership in Home Bound, resigning from the company. The home care company has seven offices located in Illinois and Nevada. They are still operating and it wasn’t made clear during these proceedings what impact this ruling may have on the company in the future financially.
According to the Daily Southtown news article, Home health care boss admits to kickbacks, written by Mike Nolan:
“The government alleged that from at least December 2006 through September 2014, Home Bound contracted with 20 doctors, paying them between $1,000 and $4,000 a month in exchange for referring elderly patients covered by Medicare to Home Bound, the release said. Those doctors completed paperwork showing that the patients were confined to their homes and eligible for medical care, although the government contended that Home Bound billed Medicare for medically unnecessary services.”
The initial complaint against Romy Macasaet, Jr. was filed in April, 2012. The reimbursement payback will take place over time, in installments, with the final payment being made by February, 2023. The company ownership that Mr. Macasaet still holds will be divested within 120 days, as part of the plea agreement.
The company moving forward has agreed to implement a new agreement with the U.S. Department of Health and Human Services to establish new policies and procedures that will bring it into compliance with the law regarding home health care companies.
Mr. Macasaet will be sentenced in February, 2017 and faces up to five years in prison, in addition to the fines levied during the plea agreement. The federal government, through the Center for Medicare and Medicaid Services (CMS) has been taking a more proactive approach in recent years to curtail fraud within the home care industry and this is one more case that has finally reached a conclusion.