RIVERSIDE, Ca - Alta Vista Healthcare & Wellness Centre, LLC (Alta Vista) and its management company, Rockport Healthcare Services (Rockport), have agreed to pay a settlement of $3.825 million to the United States and California. The allegations against them are that they submitted false claims to Medicare and Medicaid by paying kickbacks to physicians to induce patient referrals. The negotiated settlement amount took into account the financial capacity of Alta Vista and Rockport.
The Anti-Kickback Statute prohibits the act of providing or receiving remuneration in exchange for referrals of items or services covered by federally funded programs such as Medicare and Medicaid. The purpose is to prevent financial incentives from influencing medical decision-making and to prioritize the patient's best interests.
Between 2009 and 2019, Alta Vista allegedly provided gifts to physicians under the supervision of Rockport. These gifts allegedly included expensive dinners for the physicians and their spouses, golf trips, limousine rides, massages, e-reader tablets, and gift cards worth up to $1,000. Alta Vista allegedly provided monthly stipends ranging from $2,500 to $4,000 to these physicians, claiming that it was for their role as medical directors. One possible reason for these gifts and payments was to encourage the physicians to recommend patients to Alta Vista.
It is alleged that the conduct of the defendants led to the submission of false claims to Medicare and California's Medicaid programs. The California Medicaid program is jointly funded by the federal government and California. As per the settlement agreement, a payment of $3,228,300 will be made to the United States and $596,700 will be paid to California.
According to the Department of Justice, the announcement of a settlement is related to a complaint filed in 2015 by a former accounting employee named Neyirys Orozco. The complaint was filed under the qui tam provisions of the False Claims Act, which allows private individuals to bring a lawsuit on behalf of the government and receive a portion of any resulting funds. As a result of the federal government's recovery in this case, Orozco is set to receive $581,094.
The Department of Justice says Alta Vista and Rockport have agreed to settle their False Claims Act liability and have also signed a Corporate Integrity Agreement with the Department of Health and Human Services' Office of the Inspector General for a period of five years. The agreement includes various compliance obligations, including an Independent Review Organization's assessment of the physician relationships of Alta Vista and Rockport.
The case was managed by various organizations including the Civil Division's Commercial Litigation Branch, Fraud Section, the U.S. Attorney’s Office for the Central District of California, and the California Department of Justice. The HHS-OIG provided investigative support.
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