Sundae Williams, the owner of Serenity Marketing Inc., made unsolicited phone calls to recruit patients, including Medicare beneficiaries, for contracted home health agencies. Williams and Serenity then referred those patients to the home health agencies in exchange for payments on a per-patient basis. Williams was convicted on one count of conspiracy and six counts of soliciting and receiving remuneration in return for the referral of Medicare patients. Williams was the fourth person to be convicted as part of a larger federal investigation into Serenity and the home health agencies. The others have pleaded guilty to a variety of Medicare fraud charges, including billing for unnecessary services, paying kickbacks and falsely certifying patients for nursing services.
The convictions highlight the risks involved with these types of marketing arrangements that are becoming more common, especially if the compensation is not properly structured. In this case, Serenity "employees were trained to cold-call Medicare beneficiaries and convince them to accept home health services." If a Medicare beneficiary expressed interest, Serenity employees obtained the beneficiary's personal information, including their Medicare number, and provided it to the home health agencies that had agreed to pay Serenity for the referrals. This is similar to other cases we have seen in which a contractor, in many cases offshore, is engaged to call potential home health and durable medical equipment clients from a boiler-room operation and qualify them for the provider. A second enterprise related to the cold-caller, or in some cases, the provider itself, then calls qualified leads and attempts to sell them on their services.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
