Healthcare Fraud: ROMY MACASAET JR. Admitted That he Paid Illegal Kickbacks to Procure Referrals of Elderly Patients on Medicare
Owner of Illinois Home Health Company Admits Paying Illegal Kickbacks to 20 Medical Directors for Referrals of Medicare Patients
CHICAGO — The owner of a home health care company headquartered in Lemont admitted in federal court today that he paid illegal kickbacks to procure referrals of elderly patients on Medicare.
ROMY MACASAET JR. paid kickbacks to medical directors to obtain referrals of Medicare beneficiaries to his company, Home Bound Healthcare Inc., which was one of the largest home healthcare and hospice companies in Illinois. Macasaet acknowledged in a plea agreement that he retained and paid Medical Directors a monthly fee solely for the purpose of obtaining patient referrals, and not for medical services. Macasaet also acknowledged that he used Medical Director agreements as a way to conceal the payment of kickbacks.
Between approximately December 2006 and September 2014, Macasaet paid $789,327 in bribe payments to approximately 20 medical directors, according to the plea agreement. As a result of the payments, Home Bound improperly sought and received Medicare reimbursements totaling several million dollars.
Macasaet, 47, of Homewood, pleaded guilty to one count of violating the Anti-Kickback Statute. The conviction is punishable by up to five years in prison. U.S. District Judge Samuel Der-Yeghiayan set sentencing for Feb. 15, 2017, at 10:30 a.m.
Macasaet and Home Bound also agreed to pay the United States $6.8 million to resolve the civil false claim and anti-kickback allegations, per the terms of a settlement agreement announced today. The agreement settles claims that Home Bound and its subsidiaries violated the federal False Claims Act and Anti-Kickback Statute by obtaining referrals through illegal kickbacks that served as financial inducements for false certifications of eligibility for home health services, and by improperly submitting those false claims to Medicare for reimbursement.
As part of the civil settlement, Macasaet agreed to immediately resign his employment with Home Bound and refrain from seeking future employment with the company. Macasaet further agreed to divest his ownership interest in Home Bound within 120 days of formal entry of the agreement. The settlement was reached by the Justice Department on behalf of the Office of the Inspector General of the U.S. Department of Health and Human Services.
Contemporaneous to the settlement agreement, Home Bound and the HHS Inspector General’s Office entered into a corporate integrity agreement to promote compliance with the directives of Medicare, Medicaid, and other federal health care programs. As part of the integrity agreement, Home Bound must establish a compliance program to develop and implement policies, procedures, and practices designed to ensure compliance with the requirements of federal health care programs.
The plea agreement and civil settlement were announced by Zachary T. Fardon, United States Attorney for the Northern District of Illinois; Lamont Pugh III, Special Agent-in-Charge of the Chicago Regional Office of the U.S. Department of Health and Human Services Office of Inspector General; and Michael J. Anderson, Special Agent-in-Charge of the Chicago Office of the Federal Bureau of Investigation. Substantial investigative assistance was provided by the U.S. Department of Labor Office of Inspector General, and the Chicago Field Office of the U.S. Department of State Diplomatic Security Service.
The government is represented in the criminal case by Assistant U.S. Attorney Sunil Harjani, and in the civil case by Assistant U.S. Attorney David R. Lidow.