Ex-Tri-Cities doctor, staffing company accused of Medicare kick-back scheme

A former Richland doctor approved orders costing more than $750,000 in six months for Medicare patients he may never have seen or talked to, according to a federal settlement agreement.

Dr. William Edward Salko, a doctor of osteopathic medicine, and Jackson & Coker LocumTenens have agreed to pay $700,000 to the federal government to resolve allegations they participated in a kick-back scheme to bill Medicare for tests and equipment that were not medically necessary.

Medicare provides health insurance for elderly and disabled U.S. citizens.

Nationwide Health Companies used telemarketing companies to contact people with Medicare benefits and speak to them about obtaining medical equipment or testing at no cost, according to the U.S. Attorney’s Office for the Eastern District of Washington.

The telemarketers obtained personal information to generate documentation that made it appear that the people they called were the patients of a doctor who was treating them for a specific medical problem that would require a lab test or medical equipment.

Jackson & Coker, a company that recruits doctors and other health care professionals for temporary medical assignments, contacted Salko about a telemedicine opportunity that would require him to prescribe medical equipment.

Although the settlement agreement did not detail what equipment would be authorized, it points out that knee and lower back braces require a face-to-face visit with the patient and a physical exam for Medicare reimbursement of prescriptions.

Nationwide generated fraudulent orders for genetic tests and equipment and then emailed a link to Salko.

The link provided medical information that included a purported medical history, personal information, symptoms and exam notes, according to the settlement agreement.

Salko would review the charts using software called “Zoho.”

“Dr. Salko then electronically approved the orders, causing his signature to be electronically added to the documentation,” the settlement agreement said. “These exam notes and other medical documentation were false and fraudulent in that they documented physical exams that Dr. Salko did not conduct, medical assessments that Dr. Salko did not make and treatment plans that Dr. Salko did not devise or carry out.”

Salko approved nearly every order, usually within a few minutes of accessing the order information, according to the settlement agreement.

The settlement agreement is not clear about whether Salko approved only prescriptions for medical equipment or also participated in approving genetic testing orders.

Jackson & Coker charged Nationwide a daily fee of $45 plus $35 for each order approved by Salko, although Nationwide stopped making payments on the contract, according to the settlement agreement.

Salko was paid $15 by Jackson & Coker for every order he approved, according to the settlement agreement.

The $700,000 to be paid to the federal government by Salko and the recruitment company includes $250,000 of restitution.

The former owner and president of Nationwide, David Santana, agreed in September to plead guilty to felony health care fraud conspiracy in Massachusetts.

Jackson & Coker cooperated with the investigation and has taken action to improve its controls related to placing providers with telemedicine clients, according to the Eastern Washington District U.S. Attorney’s Office.

Vanessa Waldref, U.S. Attorney for the Eastern Washington District, said the settlement is a signal to physicians they will be held accountable for participating in Medicare fraud schemes.

“Physicians and health care staffing cannot ignore red flags about whether they are engaged in a Medicare fraud scheme,” she said. “Schemes like that employed by Nationwide only work when doctors are willing to turn a blind eye and issue prescriptions and orders for patients that they are not treating.”

Health care providers and businesses that exploit Medicare through fraudulent telemedicine schemes waste valuable taxpayer dollars, said Steven Ryan, special agent in charge with the U.S. Department of Health and Human Services, Office of Inspector General.

The investigation that led to the settlement was conducted by the U.S. Attorney’s Office for the Eastern District of Washington and the U.S. Department of Health and Human Services, Office of Inspector General, Seattle Field Office. Assistant U.S. Attorneys Dan Fruchter and Tyler Tornabene, and Law Clerk Jacquelyn Nader, handled the matter.