Roland Borrasi, MD, has been convicted of Medicare fraud after the U.S. Court of Appeals for the Seventh Circuit in Chicago used the "one purpose test" to determine the legality of payments Dr. Borrasi received from an Illinois hospital, according to the case briefing.
Dr. Borrasi owned Integrated Health Centers, a corporate group of healthcare providers in Romeoville, Ill. Between 1999 and 2002, Dr. Borrasi accepted payments from Rock Creek Center, a licensed inpatient psychiatric hospital in Lemont, Ill., in exchange for Medicare patient referrals.
Over that time span, $647,204 was paid to Dr. Borrasi and others by Rock Creek, and in 2001 alone, Dr. Borrasi referred approximately 484 Medicare patients to the facility. To conceal the payments, Dr. Borrasi was placed on the Rock Creek payroll and named "service medical director."
Dr. Borrasi claimed the payments were compensation for bona fide services provided. Using the one purpose test, the court determined that even if the hospital's payments compensated the doctor's professional services, the Medicare fraud statute was violated because a portion of the payments were intended to induce patient referrals.
Of the one purpose test, Scott Becker, JD, CPA, of McGuireWoods, says, "This is very consistent with the traditional reading of the anti-kickback statute. It means that a payment relationship must be for services that are truly needed, fair market value and wholly unrelated to referrals. In the changing face of physician-hospital relationships, it is critical that financial relationships be able to line up clearly on these measures."
Read the case brief on Dr. Roland Borrasi and the one purpose test.
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Dr. Borrasi owned Integrated Health Centers, a corporate group of healthcare providers in Romeoville, Ill. Between 1999 and 2002, Dr. Borrasi accepted payments from Rock Creek Center, a licensed inpatient psychiatric hospital in Lemont, Ill., in exchange for Medicare patient referrals.
Over that time span, $647,204 was paid to Dr. Borrasi and others by Rock Creek, and in 2001 alone, Dr. Borrasi referred approximately 484 Medicare patients to the facility. To conceal the payments, Dr. Borrasi was placed on the Rock Creek payroll and named "service medical director."
Dr. Borrasi claimed the payments were compensation for bona fide services provided. Using the one purpose test, the court determined that even if the hospital's payments compensated the doctor's professional services, the Medicare fraud statute was violated because a portion of the payments were intended to induce patient referrals.
Of the one purpose test, Scott Becker, JD, CPA, of McGuireWoods, says, "This is very consistent with the traditional reading of the anti-kickback statute. It means that a payment relationship must be for services that are truly needed, fair market value and wholly unrelated to referrals. In the changing face of physician-hospital relationships, it is critical that financial relationships be able to line up clearly on these measures."
Read the case brief on Dr. Roland Borrasi and the one purpose test.
Related Articles on the Anti-Kickback Statute:
Health Alliance of Greater Cincinnati, Christ Hospital Pay $108M to Settle Federal Kickback Accusations
10 Key Legal Issues Facing Ambulatory Surgery Centers
10 Recent Stark, False Claims and Kickback Lawsuits Involving Hospitals and Health Systems