Sunday, March 12, 2017

Federal Jury Finds Mental Health Facility Administrator Guilty of Kickbacks for Referrals

Payment for recruiting and referral of patients. When is it marketing and when is it an illegal kickback? In a recent case, such payments were viewed as illegal kickbacks. 

On February 14, 2017, a federal jury deliberated after four days of trial and found a former Shreveport mental health facility administrator guilty Thursday of taking part in a kickback scheme. Tom McCardell of Louisiana was found guilty of 14 counts of paying illegal kickbacks. The jury only deliberated approximately four hours before delivering the guilty verdict. 

According to the evidence presented, from July of 2011 to November 2012, Mr. McCardell was the administrator of Physicians Behavior Hospital (PBH) in Shreveport, Louisiana a 24 bed behavioral health hospital. He made payments (viewed as kickbacks) to an Alabama resident, who had no medical training or background, to recruit and refer patients to PBH for psychiatric and substance abuse treatment. 

The hospital would then purchase bus tickets for the patients to travel to PBH in Shreveport. Many of the patients traveled unattended without escort. Mr. McCardell allegedly arranged for the payments to be issued in the name of the patient recruiter’s son which was used as evidence that there was knowledge it was illegal and was done to avoid detection. 

Evidence was also introduced that Mr. McCardell ordered PBH personnel to create an “employee file” in the name of the recruiter’s son in order to provide cover for the  payment (kickback) arrangement. 

During this time period, Mr. McCardell allegedly approved the hospital paying the recruiter’s son checks totaling $41,000 to which he was not entitled. The government alleged that as a result of the illegal kickback scheme, the hospital billed more than $6.7 million dollars to Medicare and was paid more than $1.2 million dollars.

Attorney Commentary: The issue with kickback violations is that the entire billing for the patient is viewed as a "false claim" even if medically necessary. This is why it is critical to be compliant. Further, when the case shows criminal knowledge or intent, there is a greater likelihood of criminal prosecution.  The red flags in this case were: payments disguised as employee payments, the hospital buying bus tickets, the recruiter not having training on who would qualify for medical necessity, and the fact that the son did not perform any services for his payments.  

Posted by Tracy Green, Esq.
Work: 213-233-2260


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