California nurse pleads guilty to Medicare scheme

A Sacramento, Calif., nurse pleaded guilty to conspiring with home health agencies in a scheme where the nurse referred Medicare beneficiaries to the agencies in exchange for illegal kickbacks, U.S. Attorney McGregor W. Scott announced Oct. 10.

John Eby, RN, was a case manager at a nonprofit hospital, helping Medicare patients choose post-acute care providers, according to court documents. From September 2015 to November 2018, Mr. Eby directed Medicare beneficiaries to home health agencies in Folsom and El Dorado Hills, Calif., and the home health agency owners paid him illegal kickbacks for the referrals.

In total, Mr. Eby referred about 55 patients in exchange for kickbacks, according to court records. Agencies receiving beneficiary referrals by paying kickbacks aren't eligible for Medicare reimbursement, but the agencies received about $250,000 from Medicare for services provided to beneficiaries.

The nurse pleaded guilty to conspiracy and one count of accepting a $1,000 cash kickback in exchange for five Medicare beneficiary referrals to the agency in Folsom.

Mr. Eby's sentencing is scheduled for Jan. 9, 2020. He faces a maximum prison sentence of 15 years and a maximum fine of $250,000 or twice the gross gain or loss for each charge.  

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A Sacramento, Calif., nurse pleaded guilty to conspiring with home health agencies in a scheme where the nurse referred Medicare beneficiaries to the agencies in exchange for illegal kickbacks, U.S. Attorney McGregor W. Scott announced Oct. 10.

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