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View Winners → Crime Jun 22, 2023
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A Riverside-based skilled nursing facility will pay $3.8 million to the federal and state governments to settle a civil action alleging payments to doctors to provide referrals to the care and rehabilitation center, officials announced Wednesday.
“Decisions that affect patient health should be made solely on the basis of a patient’s best interest,” California Attorney General Rob Bonta said. “When a healthcare company cheats and offers kickbacks to gain an unfair advantage, it jeopardizes the health and well-being of those who rely on its services.”
Alta Vista Healthcare & Wellness Centre, which operates a nursing home on Garfield Street, along with its management company Rockport Healthcare Services were the target of an investigation by the California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse, as well as the U.S. Department of Justice. The probe began when prosecutors received information that multiple doctors had received monetary incentives from early 2009 to the end of 2019 to encourage them to refer patients to the Alta Vista facility, according to state officials.
Alta Vista and Rockport were accused of violating the California False Claims Act and the federal Anti-Kickback Statute and False Claims Act.
“These illegal schemes make public services and programs costlier and ultimately waste valuable taxpayer dollars,” Bonta said. “This settlement demonstrates our commitment to protecting the integrity of Medi-Cal and the taxpayer dollars that support the program.”
Medi-Cal is the state’s federally supported Medicaid program, providing health insurance services to the indigent, disabled and other qualifying recipients.
“Kickbacks can impair the independence of physician decision-making and waste taxpayer dollars,” Deputy U.S. Assistant Attorney General Brian Boynton said. “The Justice Department is committed to preventing illegal financial relationships that undermine the integrity of our public healthcare programs.”
Prosecutors said Alta Vista’s representatives provided kickbacks to doctors in the form of cash and gifts during the alleged decade-long scheme.
“These referrals resulted in millions of dollars in Medicare and Medi-Cal reimbursement to Alta Vista and Rockport,” the California Department of Justice said. “Inducing or rewarding doctors to steer or refer Medi-Cal and Medicare patients … can lead to over-utilization of publicly-funded health care services, increased costs for public programs, corruption in medical decision-making and unfair competition.”
The specific number of referrals was not provided.
Under the settlement the federal government will receive a little more than $3.2 million in penalties and reimbursement, and California will receive $596,700.
