Federal court house in Hammond

Medicare Fraud complaint filed against physician, his siblings

Contributed By:The 411 News

And a home health agency they owned and operated

Hammond -- United States Attorney Thomas L. Kirsch II announced today the filing of a civil Medicare fraud complaint against physician Conrado Castor, age 74, of Schererville, Indiana, American Home Health Services, Inc. of Schererville, Indiana and its owners, Aurea Duncan, age 59, of Crown Point, Indiana, and Jacob Castor, age 58, of Dyer, Indiana for submitting claims to Medicare in violation of the Stark Law.

The Stark Law provides that the government will not pay for designated health services if such services were furnished by an entity that had a financial relationship with an immediate family member of the referring physician because such financial relationships can cause overutilization of those services and compromise the physician’s professional judgment. The False Claims Act prohibits an entity from knowingly submitting claims for payment for such services.

The complaint alleges that during 2008-2014, physician Conrado Castor referred numerous Medicare patients for the purpose of receiving home health care services to three home health agencies owned by his immediate family members: American Home Health Services, Inc., Adarna Home Health Care Services, Inc., and Amore Home Health Care Services, Inc.

All three entities were owned by Dr. Castor’s immediate family members and billed Medicare for home health services for patients referred by Dr. Castor.

Medicare paid over 400 claims totaling over $1.2 million to American, Adarna, and Amore for Dr. Castor’s home health care referrals. Defendant American Home Health Services, Inc. is owned by Dr. Castor’s sister, Aurea Duncan, and, during an earlier time period, Dr. Castor’s brother, Jacob Castor. Medicare paid over 300 claims totaling more than $800,000 to American for Dr. Castor’s home health care referrals.

The False Claims Act allows the federal government to recover three times the amount of the false and fraudulent claims submitted to Medicare plus a civil penalty of $5,500 to $11,000 per false claim submitted during 2008-2014. A small portion of recoveries under the federal False Claims Act, three percent, is used to fund the cost of future health care fraud investigations and cases.

“Medical decisions should be based on the best interests of patients and not on the personal financial interests of referring physicians and their family members,” said United States Attorney Thomas L. Kirsch II. “My Office will continue to make it a high priority to file civil suits to recover funds that were paid out under the Medicare program because of health care fraud.”

This suit was filed as the result of a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act. The case was investigated by the United States Attorney’s Office for the Northern District of Indiana and is being handled by Assistant United States Attorneys Wayne T. Ault and Dirk D. De Lor.

Story Posted:01/10/2020

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