Patient Recruiter Found Guilty in $1.3 Million Medicare Kickback Scheme

On July 30, 2019, a federal jury in Detroit, Michigan, found a patient recruiter guilty for his role in a scheme involving approximately $1.3 million in fraudulent Medicare claims for home health care that were procured through the payment of illegal kickbacks.

Following a six-day trial, Dominic Trumbo, 45, of Lexington, Kentucky, was found guilty of one count of conspiracy to pay and receive health care kickbacks and three counts of receipt of health care kickbacks.

According to evidence presented at trial, from 2009 to 2017, Trumbo, owner of Trumbo Consulting Agency, solicited and received kickbacks in exchange for referring Medicare beneficiaries to serve as patients at multiple home health agencies. These agencies then submitted claims to Medicare for home health services that were purportedly provided to those beneficiaries.

The Fraud Section leads the Medicare Fraud Strike Force, which is part of a joint initiative between the DOJ and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country. Since its inception in March 2007, the Medicare Fraud Strike Force, which maintains 14 strike forces operating in 23 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion.

The Federal Anti-Kickback Statute (AKS) makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce or reward referrals of items or services reimbursable by a Federal health care program. A person need not have actual acknowledge of the AKS or specific intent to violate the AKS. Since home health care services are a highly regulated area, in order to avoid non-compliance with the AKS and other applicable laws/regulations governing such matter, home health agencies are well advised to consult with a knowledgeable attorney when setting up practice and periodically during practice in order to identify potential areas of non-compliance so that remedial measures can be taken to avoid or at least mitigate against significant adverse enforcement actions that can result

For additional information on the above matter or any issue concerning the Federal Anti-Kickback Statute, government investigations, or compliance, please contact Robert S. Iwrey, Esq. at (248) 996-8510 or riwrey@thehlp.com.

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