Orlando Surgeon Owes $500,000 for Kickback Scheme

An Orlando skilled nursing facility and an orthopedic surgeon have agreed to pay $1.5 million to the federal government to resolve allegations that they had an illegal kickback scheme that involved Medicare and TRICARE patients.

The Justice Department alleged that Conway Lakes Health & Rehabilitation Center and its management company Clear Choice Health Care had a kickback arrangement with Orlando orthopedic surgeon Dr. Kenneth Krumins. The nursing facility paid Dr. Krumins under a sham “medical director” agreement in exchange for the referral of Medicare and TRICARE patients. The Justice Department also claims that Dr. Krumins engaged in a similar scheme with a related home-health agency.

This type of financial agreement violates the Anti-Kickback Statute, which prohibits individuals and institutions from offering or accepting payments to influence others to give them referrals. It is also a violation of the physician self-referral law, or Stark Law.

Conway Lakes, Clear Choice, and their executives have agreed to pay $1 million to settle the allegations, which Dr. Krumins has agreed to pay $500,000.

In a prepared statement, U.S. Attorney Maria Chapa Lopez said, “Our office will aggressively pursue health care providers who engage in kickback schemes…. These schemes drive up costs and undermine patient care. The United States Attorney’s Office will continue to advocate for the integrity of federally subsidized health programs and for the proper care of our seniors and our veterans.”

The allegations that were resolved by the settlement agreements were originally brought in a whistleblower lawsuit filed under the False Claims Act by a former employee of Conway Lakes, Jonathan Montes de Oca. The Act allows private citizens who have knowledge of fraud against the government to bring an action on behalf of the government and share in any recovery. Montes de Oca will receive $267,000 as his share of the recovery.