Northwest Indiana doctor submitted $1.2M in fraudulent Medicare claims, complaint alleges - Insurance News | InsuranceNewsNet

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January 10, 2020 Newswires
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Northwest Indiana doctor submitted $1.2M in fraudulent Medicare claims, complaint alleges

Times (Munster, IN)

Jan. 10--HAMMOND -- Schererville physician Conrado Castor is facing allegations that he submitted fraudulent Medicare claims.

United States Attorney Thomas Kirsch II announced a civil complaint against Castor, 74, and owners of American Home Health Services, Inc., Aurea Duncan, 59, of Crown Point, and Jacob Castor, 58, of Dyer, for submitting Medicare claims in violation of the physician self-referral law, also known as Stark law.

According to Stark law, physicians cannot refer patients to receive health services payable by Medicare to entities that the physician or an immediate family member have a financial relationship. Financial relationships include ownership and investment interests and compensation arrangements, according to United States Code.

During 2008 to 2014, Castor allegedly referred various Medicare patients for home health care to agencies owned by his immediate family members, including American Home Health Services, Inc., Adarna Home Health Services, Inc. and Amore Home Health Care Services, Inc., according to the complaint.

The complaint states that Medicare paid more than 400 claims totaling $1.2 million to the three home health care agencies based on Castor's referrals.

According to the release and documents from the Secretary of State, American Home Health Services is owned by Duncan, Castor's sister, and by Castor's brother, Jacob Castor. Medicare paid more than 300 claims totaling more than $800,000 to American for Conrado Castor's referrals, the release states.

"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," Kirsch said.

"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."

Under the False Claims Act, the federal government is allowed to recover three times the amount of false/fraudulent claims submitted to Medicare, in addition to a penalty of $5,500 to $11,000 per false claim submitted during 2008-2014.

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