An Orlando rehabilitation center and orthopedic surgeon charged with violating anti-kickback laws have settled with a collective $1.5 million payment to the federal government.
The settlement is the fallout of a lawsuit brought by Jonathan Montes de Oca against his former employer, Conway Lakes Health & Rehabilitation Center. According to James Young, the Morgan & Morgan attorney who represented Montes de Oca, his client uncovered “a fairly organized scheme” by Conway Lakes to pay Central Florida physicians for referrals, then bill the federal government for the rehab services.
“When he saw how things were working that’s when he started putting the pieces together and contacted us,” Young said. The Jacksonville lawyer said Montes de Oca did not reach out to his firm intent on filing a complaint against Conway Lakes.
“A lot of people who call whistleblower attorneys, like us, want clarification,” Young said. “So a lot of times — unlike an auto accident or workers’ compensation — they have not yet made a decision that they want to file suit. A lot of times they just want information.”
Montes de Oca described several scenarios, including free dinners and tickets to sporting events, that violated the anti-kickback statute and the Stark Law, which prohibits health care fraud and abuse. This prompted Young and his team to pass the information to law enforcement agents.
“The government agreed with our allegations, and were able to resolve the case against the defendants,” Young said.
He added, “This young man risked everything to bring this case.”
Greenberg Traurig shareholder Greg Kehoe served as Conway Lake’s legal counsel in the case. He said his client “appreciates the government’s efforts to reduce waste in the Medicare system” but emphasized “there’s no mention of fault on the part of Conway Lakes” in the settlement.
“All of the medical care given by Conway Lakes was appropriate and proper,” Kehoe said. “You settle these cases for economic considerations. Conway Lakes is interested in doing what they did before … and operating in the best interests of their patients.”
Montes de Oca is set to receive 19 percent, or about $285,000, of the settlement, as part of government provisions to protect and reward whistleblowers who act in the public interest.
Read the settlement: