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Home Health Company Pays $28K for Employing "Excluded" Individual

Publication date: 
Monday, April 12, 2021

Leonard C Boyle, Acting United States Attorney for the District of Connecticut, today announced that CARECO MEDICAL, INC. and its owner and CEO, HELGA PFANNER, have entered into a civil settlement agreement with the federal government in which they will pay $28,246 to resolve allegations that they improperly employed an individual who was excluded from all federal healthcare programs.  CareCo Medical (“CareCo”) is a Waterford-based home healthcare organization that provides skilled nursing services, medical social worker services, and rehabilitative therapies.

Acting U.S. Attorney Boyle explained that when the U.S. Department of Health and Human Services, Office of the Inspector General (HHS-OIG) excludes an individual or entity from federal health care programs, no program payments may be made for items or services furnished by that excluded individual or entity.  In September 1999, HHS-OIG issued a Special Advisory Bulletin to provide guidance to health care providers who might employ or contract with an excluded individual or entity.  In May 2013, HHS-OIG issued an Updated Special Advisory Bulletin containing additional guidance.  Both the original and updated Special Advisory Bulletins advised that, in order to avoid potential liability, health care providers should check the List of Excluded Individuals/Entities on the HHS-OIG web site (http://oig.hhs.gov/exclusions).

In 2012, Todd Roberts, a physical therapist, pleaded guilty to one count of obstructing a federal audit and, pursuant to a related civil settlement agreement, agreed to pay $328,828.  In addition, Roberts entered into a six-year Integrity Agreement with the U.S. Department of Health and Human Services designed to ensure future compliance with the requirements of the Medicare program.  Roberts later defaulted on his obligations under the Integrity Agreement and was excluded from all federal health care programs in 2015.

In November 2018, CareCo and Pfanner hired Roberts for a management position at CareCo.  Roberts served in that position until March 2019.

To resolve their liability for hiring and employing Roberts while he was excluded from all federal healthcare programs, CareCo and Pfanner will pay $28,246.

This matter was investigated by HHS-OIG and is being prosecuted by Assistant U.S. Attorney Richard M. Molot.

People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at (203) 777-6311.

Additional Details
URL
Component
USAO - Connecticut;
OIG
Department of Health and Human Services OIG