Prema Thekkek, owner of six skilled nursing facilities, and her Vacaville-based management company, Paksn Inc., have agreed to a $45.6 million consent judgment to resolve allegations of kickbacks and submission of false claims to Medicare, as press released by the U.S. Attorney's Office.
The nursing facilities scrutinized are Kayal Inc., Nadhi Inc., Oakrheem Inc., Bayview Care Inc., Aakash Inc., and Nasaky Inc. Between 2009 and 2021, these facilities were accused of violating the Anti-Kickback Statute, aiming to curtail financial incentives that may affect medical decision-making.
Thekkek and Paksn directed the SNF Defendants to engage in medical directorship agreements, seemingly compensating for administrative services. However, the agreements were allegedly used for a pay to physicians in exchange for patient referrals. Patient referrals influenced the hirings and terminations of physicians at these facilities.
Case files revealed unethical conduct. For instance, a Paksn employee informed Thekkek of two new hires who guaranteed at least ten patient referrals to secure $2,000 per month. In another instance, a doctor stopped receiving payment after referring only two patients, essentially putting finance over the patients' best interests.
U.S. Attorney Martin Estrada stressed decisions should be based on sound medical judgment, not self-interest. Principal Deputy Assistant Attorney General Brian M. Boynton denounced kickbacks, noting too compromise taxpayer dollars and physician independence. Maintaining the integrity of public health care programs is a priority for the Department of Justice (DOJ).
The settlement report reveals that the defendants will enter into a consent judgment of $45,645,327.25. Over the next five years, they are to make scheduled payments of a minimum of $385,000 to the United States, reflecting their present inability to pay fully. Moreover, they must adhere to a five-year corporate integrity agreement with the Department of Health and Human Services Office of the Inspector General (HHS-OIG).
Trilochan Singh, Paksn's ex-Vice President of Operations and COO, filed the original whistleblower complaint under the False Claims Act in 2015. His report triggered the government's intervention against the SNF Defendants.
Aside from resolving their False Claims Act liability, the defendants must undergo an Independent Review Organization's assessment of their physician relationships. The review's outcomes will dictate any additional measures required for federal healthcare compliance.
The Department of Health and Human Services urges the public to report suspected fraud, waste, and abuse in health care. Citizens can report such activities by calling 800 HHS TIPS (800-447-8477).
