Nursing Home Must|Fork Over $3.2 Million

     HOUSTON (CN) – A Texas nursing home manager will pay $3.2 million to settle state and federal allegations it took kickbacks from ambulance companies for referring Medicaid and Medicare patients to them.
     Regent Management Services, of Galveston, manages 11 nursing homes in Texas and one in Reno, Nev.
     Regent touts its properties on its website as “elegant” and “luxurious” and says all its residents are treated with an individualized care plan.
     But the Department of Justice said Monday that Regent violated the Anti-Kickback Statute by accepting free or rebated ambulance rides for residents in return for referring lucrative Medicaid and Medicare patients to the ambulance companies.
     “The settlement is believed to be the first in the nation to hold accountable medical institutions (hospitals and skilled nursing facilities) rather than ambulance companies for these kind of ambulance ‘swapping’ arrangements,” the U.S. Attorney’s Office said in a statement.
     Texas will get $533,000, because Medicaid is jointly funded by states and the federal government.
     Prosecutors did not name any of the ambulance companies with whom Regent made the illegal arrangements.
     Gregory Demske, a lead attorney with the U.S. Department of Health and Human Services, said the deal shows that regulators are taking a holistic approach to combating health insurance fraud.
     “This settlement sends a message to the health care industry that both sides of a swapping arrangement can be held responsible for their improper actions, not just the entity that actually bills Medicare or Medicaid for the services,” he said in the statement.
     Regent said in a statement that the quality of its service was not in question. “The government did not take issue with the medical care or services Regent provided. There was no finding that any resident received unnecessary or improper care,” the company said.
     Regent did not have to admit it did anything wrong. It said it’s ponying up to avoid costly litigation.

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