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Monroe doctor to pay $640k to resolve allegations over referrals, DOJ says

Published: Oct. 12, 2021 at 12:27 PM CDT
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MONROE, La. (KNOE) - A Monroe doctor has agreed to pay $640,000 to resolve allegations that he accepted payments for referrals of home health patients, according to the U.S. Department of Justice.

This Oct. 12 news release from the United States Attorney’s Office Western District of Louisiana details the findings. It can be seen in italics, below:

United States Attorney’s Office Western District of Louisiana News Release
SHREVEPORT, La. - Acting United States Attorney Alexander C. Van Hook announced today that Dr. Llewelyn Simon, an internal medicine physician from Monroe, Louisiana, has agreed to pay the United States $640,000 to resolve allegations that he accepted payments for referrals of home health patients.

Dr. Simon served as a medical director for the now defunct United Home Care home health agency and in that capacity, received monthly payments. The United States alleged that the medical director fees exceeded the fair market value of the services provided by Simon and that the excess fees were for referrals of patients, many of whom were Medicare beneficiaries.

Congress passed the Anti-Kickback Statute to prevent financial incentives from improperly influencing medical decision-making which can lead to excessive and unnecessary services. Specifically, the Anti-Kickback Statute prohibits offering or paying anything of value to induce the referral of items or services covered by federal health care programs.

“Improper financial relationships between health care providers can lead to overutilization and increase the cost of health care services paid for by the taxpayers,” stated Acting United States Attorney Alexander C. Van Hook. “We will continue to ensure that health care decisions are based on the needs of patients rather than the financial interests of providers.”

The investigation of this matter was conducted by the Department of Health and Human Service’s Office of Inspector General. Assistant United States Attorney Melissa Theriot handled the case. The resolution was the result of a coordinated effort between federal agencies and illustrates the government’s emphasis on combating healthcare fraud. One of the most powerful tools in this effort is the False Claims Act.

Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

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