A Florida man has pleaded guilty to paying over $1 million in illegal gratuities to an employee at the Department of Veterans Affairs in exchange for referrals to his company according to an announcement from the Justice Department.
Roland Vaughn, 58, of Clearwater, FL recently entered a guilty plea in which he admitted to paying illegal gratuities to a long-time friend who worked at the VA in exchange for referrals he received for his company, Legacy Home Health, which in turned billed the VA more than $3 million for ineligible home health services.
According to facts presented in the plea agreement, in September 2017, Vaughn and the employee worked together to help Vaughn establish a company called Legacy Home Health (“Legacy”). The VA employee told Vaughn how to set the company up to submit claims for home health services to the VA’s Spina Bifida Health Care Benefits Program. For certain veterans who have children with spina bifida, the program provides for health services in the home.
The VA employee incorrectly told program beneficiaries that their family members and friends could be paid for providing home health services to the beneficiaries, even though these individuals were not “authorized providers” as required by VA regulations because, with only one exception, they did not hold certified nursing assistant licenses or other medical licensure. The VA employee told these individuals they simply had to sign up through Vaughn’s company – Legacy – the health agency that would bill for their services.
Legacy then submitted claims for home health services on behalf of the family members and friends, billing the VA as much as $88 an hour, but paying the individuals approximately $16 an hour. The VA, in turn, paid Legacy $3,039,761.36 for such claims.
In exchange for the referrals to Legacy, Vaughn paid the VA employee $1,007,205.00 in illegal gratuities.
Vaughn’s plea agreement requires him to pay restitution to the VA in the full amount of the illegal payments he made to the VA employee. Vaughn’s sentencing is set for December 6, 2019.
According to the Justice Department, he VA employee referenced in the plea agreement has been indicted by a federal grand jury. The charges pending against that defendant are allegations, and that defendant is presumed innocent unless and until proven guilty.