Former administrators at a New York City skilled-nursing facility will pay $3.46 million to settle allegations the facility switched residents' insurance, often without their full consent, and paid kickbacks to a hospital employee to recruit residents with original Medicare.
According to a May 17 news release from the Justice Department, the estate of the former owner, and a former administrator and contractor of Morris Park Nursing Home in the Bronx will pay the settlement.
According to court documents, the Justice Department alleged it is "well-known" within the skilled nursing industry that facilities receive higher reimbursements for patients enrolled in original Medicare than in Medicare Advantage.
The department alleged Tzodik Weinberg, the facilities administrator, encouraged staff to disenroll residents in Medicare Advantage plans and move them to original Medicare. Mr. Weinberg retained Maier Arm, another defendant in the suit, to manage disenrolling residents, and paid him $1,000 for each resident he disenrolled from original Medicare.
When residents were persuaded to switch plans, Mr. Weinberg and other staff did not disclose how the switch would affect the resident's coverage, according to court documents. In some cases Mr. Weinberg offered to reduce copayments for residents who chose to switch to original Medicare, the Justice Department alleged.
Prosecutors also alleged Mr. Weinberg paid kickbacks to a manager at Jacobi Medical Center, a municipal medical center in New York City, to refer patients enrolled in original Medicare to the facility.