UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF INDIANA

HAMMOND DIVISION

UNITED STATES OF AMERICA, ex rel. )

BRADLEY A. STEPHENS, Relator, )

)

Plaintiffs, )

)

v. ) Case No. 2:13CV145

)

CONRADO CASTOR, M.D., )

AMERICAN HOME HEALTH )

SERVICES, INC., AUREA DUNCAN, )

AND JACOB CASTOR, )

)

Defendants. )

____________________________________)

COMPLAINT IN INTERVENTION AND JURY DEMAND

 OF PLAINTIFF UNITED STATES OF AMERICA

INTRODUCTION

1. Plaintiff United States of America brings this action to recover statutory damages and 

civil penalties under the False Claims Act, 31 U.S.C. §§ 3729-33, and to recover damages 

and other monetary relief under the common law or equitable theories of fraud, unjust 

enrichment, and payment by mistake of fact.

2. From May 20, 2008 through January 25, 2014, immediate family members of defendant 

Conrado Castor, M.D. (Dr. Castor) owned three home health agencies: defendant 

American Home Health Care Services, Inc. (American), Adarna Home Health Care 

Services, Inc. (Adarna), and Amore Home Health Care Services, Inc. (Amore).

3. From May 20, 2008 through January 25, 2014, defendant Dr. Castor violated the False 

Claims Act by knowingly signing plans of care for, and otherwise referring numerous 

patients for home health care services to defendant American, Adarna, and Amore, which 

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were owned by his immediate family members, including two siblings and two spouses 

of siblings, in violation of the Stark Law, 42 U.S.C. §§ 1395nn. Defendant American, 

and its owners defendants Aurea Duncan and Jacob Castor, who are siblings of defendant 

Dr. Castor, and Adarna and Amore, which also were owned by defendant Dr. Castor’s 

immediate family members, then violated the False Claims Act by submitting, or causing 

to be submitted, claims for payment to the Medicare Program (Medicare), Title XVIII of 

the Social Security Act, 42 U.S.C. §§ 1395-1395kkk-1, for services provided to home 

health patients referred by defendant Dr. Castor, and receiving payment for those claims 

from Medicare, in violation of the Stark Law. From May 20, 2008 through 

January 25, 2014, Medicare paid approximately 472 claims totaling approximately 

$1,254,489.41 to defendant American, Adarna, and Amore, three home health agencies 

owned by defendant Dr. Castor’s immediate family members, for home health services 

referred by defendant Dr. Castor to those home health agencies in violation of the Stark 

Law.

JURISDICTION AND VENUE

4. This court has jurisdiction over this action under 31 U.S.C. §§ 3730(a) and 3732(a) and 

28 U.S.C. §§ 1345 and 1367(a).

5. Venue is proper in this District under 31 U.S.C. § 3732(a) and 28 U.S.C. §§ 1391(b) 

and (c) because defendants can be found in, are authorized to transact business in, and are 

transacting business in the Northern District of Indiana, and because defendants 

committed acts within this District that violated 31 U.S.C. § 3729.

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PARTIES

6. Plaintiff United States of America (United States), acting through the United States 

Department of Health and Human Services (HHS) and the Centers for Medicare and 

Medicaid Services (CMS), which administers the Health Insurance Program for the Aged 

and Disabled established by Title XVIII of the Social Security Act, 42 U.S.C. §§ 1395 

§§ 1395-1395kkk-1 (Medicare).

7. Relator, Bradley Stephens, is an individual residing in Lake County, Indiana.

8. Pursuant to 31 U.S.C. § 3730(b)(1), Mr. Stephens brought this action against defendants 

Conrado Castor, M.D., American Home Health Services, Incorporated, and Aurea 

Duncan on behalf of the United States.

9. Defendant Conrado Castor, M.D. (Dr. Castor) resides in Schererville, Indiana in Lake 

County in the Northern District of Indiana. During the time period relevant to the 

allegations in this Complaint, defendant Dr. Castor was a physician in Lake County, 

Indiana who was engaged in business as a Medicare provider of physician services.

10. Defendant American Home Health Services, Inc. (American) was engaged in business as 

a Medicare provider of home health services in Lake County, Indiana from May 20, 2008 

through January 18, 2014.

11. Defendant Aurea Duncan (Duncan) resides in Crown Point, Indiana in Lake County in 

the Northern District of Indiana. Defendant Duncan incorporated American on 

February 10, 2005 and has been American’s President since that time. Defendant 

Duncan was a 50% shareholder of American from its inception until August 2008, at 

which time she became the 100% shareholder of American. Defendant Duncan is the 

sister of defendant Dr. Castor.

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12. Defendant Jacob Castor resides in Munster, Indiana in Lake County in the Northern 

District of Indiana. Defendant Jacob Castor owned approximately 25% of American 

from May 2008 until August 2008. Defendant Jacob Castor is the brother of defendant

Dr. Castor.

THE LAW

The False Claims Act

13. The False Claims Act (FCA) provides for the award of treble damages and civil penalties 

for, inter alia, knowingly presenting or causing to be presented false or fraudulent claims 

for payment to the United States government and for knowingly making or using false 

records or statements material to false or fraudulent claims paid by the United States. 

31 U.S.C. §§ 3729(a)(1), (2); 31 U.S.C. §§ 3729(a)(1)(A), (a)(1)(B) (as amended).1

14. The FCA provides, in pertinent part, that a person who:

(a)(1)(A) knowingly presents, or causes to be presented, a false or fraudulent claim for 

payment or approval;

(a)(1)(B) knowingly makes, uses, or causes to be made or used, a false record or 

statement material to a false or fraudulent claim; . . .

(a)(1)(C) conspires to commit a violation of subparagraph (A), (B) ... or (G); [or]

(a)(1)(G) knowingly makes, uses, or causes to be made or used, a false record or 

statement material to an obligation to pay or transmit money or property to the 

Government, or knowingly conceals or knowingly and improperly avoids or decreases an 

obligation to pay or transmit money or property to the Government, is liable to the United 

States Government for a civil penalty of not less than $5,500 and not more than $11,000, 

 1 The FCA was amended pursuant to Public Law 111-21, the Fraud Enforcement and Recovery 

Act of 2009 (FERA), enacted May 20, 2009. Given the nature of the claims at issue, sections 

3279(a)(1) and 3279(a)(7) of the prior statute, and section 3729(a)(1)(A) and 3729(a)(1)(G) of 

the revised statute are all applicable here. Sections 3729(a)(1) and 3729(a)(7) apply to conduct 

that occurred before FERA was enacted, and sections 3729(a)(1)(A) and 3729(a)(1)(G) apply to 

conduct after FERA was enacted. Pursuant to section 4(f) of FERA, section 3729(a)(1)(B) is 

applicable to all claims in this case pending on or after June 7, 2008.

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as adjusted by the Federal Civil Penalties Inflation Adjustment Act of 1990 (28 U.S.C. 

2461 note; Public Law 104-410), plus 3 times the amount of damages which the 

Government sustains. . .

31 U.S.C. § 3729.

For purposes of the False Claims Act,

(1) the terms “knowing” and “knowingly”—

(A) mean that a person, with respect to information—

(i) has actual knowledge of the information; 

(ii) acts in deliberate ignorance of the truth or falsity of the information; or

(iii) acts in reckless disregard of the truth or falsity of the information; and

(B) require no proof of specific intent to defraud[.]

31 U.S.C. § 3729(b)(1).

15. The standard of proof under the FCA is preponderance of the evidence. 31 U.S.C. 

§ 3731(d).

The Stark Law

16. The physician self-referral law, 42 U.S.C. § 1395nn (commonly known as the Stark Law) 

prohibits a physician from referring a Medicare beneficiary for “designated health 

services” (DHS), as defined in 42 U.S.C. § 1395nn(h)(6) and 42 C.F.R. § 411.351, 

including home health services, to an entity with which the physician (or an immediate 

family member of the physician) as defined in 42 C.F.R. 411.351, has a financial 

relationship, as defined in 42 C.F.R. § 411.354, that does not satisfy the requirements of 

an applicable statutory or regulatory exception to the law. The Stark Law also prohibits 

the entity from submitting claims to Medicare for such improperly referred DHS. The 

statute specifically was designed to prevent losses to the Medicare program due to 

overutilization of DHS, increased costs, and corruption of medical judgment.

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17. The Stark Law, at 42 U.S.C. § 1395nn(a)(1), provides that:

(a) Prohibition of certain referrals

(1) In general

Except as provided in subsection (b), if a physician (or an immediate family member of 

such physician) has a financial relationship with an entity specified in paragraph (2), 

then--

(A) the physician may not make a referral to the entity for the furnishing of designated 

health services for which payment otherwise may be made under this subchapter, and

(B) the entity may not present or cause to be presented a claim under this subchapter or 

bill to any individual, third party payor, or other entity for designated health services 

furnished pursuant to a referral prohibited under subparagraph (A).

18. A “financial relationship” of a physician (or an immediate family member of such 

physician) with an entity includes “an ownership or investment interest in the entity.” 

42 U.S.C. § 1395nn(a)(2).

19. The term “immediate family member” includes siblings and spouses of siblings. See

42 C.F.R. § 411.351.

20. In 1993, the Stark Law was extended to referrals for additional DHS, including home 

health services. See 42 U.S.C. § 1395nn(h)(6)(I). See also Omnibus Reconciliation Act 

of 1993, P.L. 103-66, § 13562, Social Security Act Amendments of 1994, P.L. 103-432, 

§ 152.

21. Compliance with the Stark Law is a condition of payment by the Medicare program. The 

Stark Law prohibits Medicare from paying any claims for DHS referred in violation of 

the statute. See 42 U.S.C. § 1395nn (g)(1).

22. The regulations implementing 42 U.S.C. § 1395nn expressly require that any entity 

collecting payment for a DHS “performed pursuant to a prohibited referral must refund 

all collected amounts on a timely basis.” 42 C.F.R. § 411.353(d).

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23. A knowing violation of the Stark Law also may subject the billing entity to exclusion 

from participation in federal health care programs and civil monetary penalties. 

42 U.S.C. §§ 1395nn(g)(3), 1320a-7a(a).

The Medicare Program

24. In 1965, Congress enacted Title XVIII of the Social Security Act, known as the Medicare 

Program, to pay for the costs of certain healthcare services. Entitlement to Medicare is 

based on age, disability, or affliction with end-stage renal disease. See 42 U.S.C. 

§ 1395(c). Part A of the Medicare Program authorizes payment for home health care. 

See 42 U.S.C. § 1395d(a)(3).

25. HHS is responsible for the administration of the Medicare Program, which is 

accomplished through CMS.

26. At all times relevant to this complaint, CMS contracted with private contractors referred 

to as “fiscal intermediaries,” “carriers,” and Medicare Administrative Contractors 

(MACs), to act as agents in reviewing and paying claims submitted by healthcare 

providers. 42 U.S.C. § 1395h; 42 C.F.R. §§ 421.3, 421.100.

27. To participate in the Medicare program as a new enrollee, physicians and non-physician 

practitioners must submit a Medicare Enrollment Application, CMS Form-855I. 

Physicians also submit Form-855I if they are reactivating or revalidating Medicare 

enrollment or changing certain enrollment information.

28. Medicare regulations require providers and suppliers to certify that they meet, and will 

continue to meet, the requirements of the Medicare statute and regulations. 

42 C.F.R. § 424.516(a)(1).

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When a physician signs the certification statement contained in Form CMS-855I, he or 

she attests as follows:

I agree to abide by the Medicare laws, regulations and program instructions . . . . 

I understand that payment of a claim by Medicare is conditioned upon the claim and the 

underlying transaction complying with such laws, regulations, and program instructions 

(including, but not limited to, the Federal anti-kickback statute and the Stark law), and on 

the supplier’s compliance with all applicable conditions of participation in Medicare.

29. The National Provider Identifier (NPI) is a standard and unique health identifier for 

health care providers. All providers and practitioners must have an assigned NPI number 

prior to enrolling in Medicare.

30. To obtain Medicare reimbursement for certain outpatient items or services, providers 

submit claims using forms known as CMS 1500s. Among the information the provider

includes on a CMS 1500 form are certain five-digit codes, known as Current Procedural 

Terminology Codes, or CPT codes, that identify the services rendered and for which 

reimbursement is sought, and the unique billing identification number of the “rendering 

provider” and the “referring provider or other source.”

31. Defendants Dr. Castor and American are authorized by the Medicare program to provide 

medical services to Medicare beneficiaries, bill Medicare for legitimate, covered services 

and collect allowable payments for the services provided.

Specific Requirements for Home Health Services

32. Medicare will not pay for home health services unless a physician certifies or recertifies 

that (1) the patient is confined to the home; (2) the patient needs intermittent skilled 

nursing care, physical therapy, speech therapy, or occupational therapy; (3) a plan of care 

for the patient was established and is periodically reviewed by the physician; and (4) the 

home health services were furnished while the individual was under the care of the

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physician. Further, before a home health agency may submit to Medicare claims for 

payment for home health services, the attending physician must sign and date the plan of 

care. Rubber signature stamps are not acceptable. 42 C.F.R. § 424.22; Medicare Manual 

30.1, Rev. 68.

33. If a physician or his immediate family member has a financial relationship with a home 

health agency (as defined in 42 C.F.R. § 411.354), the Stark Law prohibits the physician 

from (1) certifying or recertifying a need for home health services; or (2) establishing or 

reviewing a plan of care with the home health agency, unless the financial relationship of 

the physician or his immediate family member satisfies the requirements of an applicable 

exception in 42 C.F.R. §§ 411.355-57.

34. Defendant American, Adarna Home Health Care Services, Inc. (Adarna), and Amore 

Home Health Care Services, Inc. (Amore) were owned by defendant Dr. Castor’s 

immediate family members. Adarna, and Amore are located in a Metropolitan Statistical 

Area (as defined in 42 C.F.R. § 412.62(f)(1)(ii)), and therefore are not located in a rural 

area as defined at 42 C.F.R. § 411.351. Therefore, the financial relationship between 

defendant Dr. Castor’s immediate family members with defendant American, Adarna, 

and Amore did not satisfy the requirements of any applicable exception, because no 

exception was available to them, including the rural provider exception at 42 C.F.R. 

§ 411.356(c). Therefore, defendant Dr. Castor’s referrals to his immediate family 

members who owned defendant American, Adarna, and Amore were prohibited under the 

Stark Law and 42 C.F.R. § 424.22.

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DEFENDANTS’ SCHEME

35. From May 20, 2008 through January 25, 2014, defendant Dr. Castor knowingly signed 

plans of care for, and otherwise referred numerous Medicare patients for the purpose of 

receiving home health care services to three home health agencies owned by his 

immediate family members in violation of the Stark Law.

36. During the relevant time period, defendant American, Adarna, and Amore were owned 

by defendant Dr. Castor’s immediate family members.

37. During the relevant time period, defendant American, Adarna, and Amore knowingly 

billed Medicare for home health services in violation of the Stark Law for patients 

referred by defendant Dr. Castor.

38. Attached as Exhibits 1A through 1E and here incorporated by reference as if set out in 

full, is a list of claims paid by Medicare for defendant Dr. Castor’s home health care 

referrals to agencies owned by his immediate family members for home health care 

services provided from May 20, 2008 through January 25, 2014.

39. During the relevant time period, Medicare paid approximately 472 claims totaling 

approximately $1,254,489.41 to defendant American, Adarna, and Amore for defendant

Dr. Castor’s home health care referrals.

American Home Health Services

40. Defendant American was incorporated in February 2005 and is engaged in business as a 

Medicare provider of home health services in Lake County, Indiana.

41. Defendant Duncan has been American’s President since it was incorporated. Defendant 

Duncan was a 50% shareholder of American from its inception until August 2008, when

she became the 100% shareholder of American.

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42. Defendant Duncan is the sister of defendant Dr. Castor.

43. Defendant Dr. Castor knowingly referred his patients to American to receive home health 

services in violation of the Stark Law and 42 C.F.R. § 424.22.

44. From May 20, 2018 through January 18, 2014, defendant American knowingly submitted 

claims to Medicare for home health services for patients referred by defendant Dr. Castor

in violation of the Stark Law and 42 C.F.R. § 424.22.

45. From May 20, 2018 through January 18, 2014, defendant Duncan caused to be submitted

to Medicare claims from defendant American for home health services for patients 

referred by defendant Dr. Castor in violation of the Stark Law and 42 C.F.R. § 424.22.

46. Attached as Exhibit 1B and here incorporated by reference as if set out in full, is a list of 

claims paid by Medicare to American for defendant Dr. Castor’s home health care 

referrals for the period from May 20, 2008 through January 18, 2014 (with patient names 

and other identifying information redacted pursuant to Fed. R. Civ. P. 5.2).

47. During the relevant time period, Medicare paid approximately 318 claims totaling 

approximately $862,709.81 to American for defendant Dr. Castor’s home health care 

referrals.

48. Defendant Jacob Castor owned approximately 25% of American from May 2008 until 

August 2008.

49. Defendant Jacob Castor is the brother of defendant Dr. Castor.

50. From May 20, 2008 through August 21, 2008, during the relevant time period of his 

ownership interest in defendant American, defendant Jacob Castor knowingly caused to 

be submitted to Medicare claims from defendant American for home health services for 

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patients referred by defendant Dr. Castor in violation of the Stark Law and 42 C.F.R. 

§ 424.22.

51. Attached as Exhibit 1C and here incorporated by reference as if set out in full, is a list of 

claims paid by Medicare to American for defendant Dr. Castor’s home health care 

referrals during the period of defendant Jacob Castor’s ownership interest in American 

from May 20, 2008 through August 21, 2008 (with patient names and other identifying 

information redacted pursuant to Fed. R. Civ. P. 5.2).

52. From May 20, 2008 through August 21, 2008, during the relevant time period of 

defendant Jacob Castor’s ownership interest in American, Medicare paid approximately 

17 claims totaling approximately $41,494.52 to American for defendant Dr. Castor’s 

home health care referrals.

Adarna Home Health Care Services

53. Adarna was incorporated in March 2004 and was engaged in business as a Medicare 

provider of home health services in Lake County, Indiana from at least July 22, 2008 

through at least January 13, 2014.

54. From at least July 22, 2008 through at least January 13, 2014, Maria Cynthia Castor was 

Adarna’s Chief Executive Officer and Owner.

55. Maria Cynthia Castor is the sister-in-law of defendant Dr. Castor and the wife of Zosimo 

Castor, one of defendant Dr. Castor’s brothers.

56. Defendant Dr. Castor knowingly referred his patients to Adarna in violation of the Stark 

Law to receive home health services.

57. Adarna and Maria Cynthia Castor submitted claims to Medicare in violation of the Stark 

Law for home health services for patients referred by defendant Dr. Castor, from at least 

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July 22, 2008 through at least January 13, 2014, in violation of the Stark Law and 

42 C.F.R. § 424.22.

58. Attached as Exhibit 1D and here incorporated by reference as if set out in full, is a list of 

claims paid by Medicare to Adarna for defendant Dr. Castor’s home health care referrals 

for the period from July 22, 2008 through January 13, 2014 (with patient names and other 

identifying information redacted pursuant to Fed. R. Civ. P. 5.2).

59. From July 22, 2008 through January 13, 2014, Medicare paid approximately 82 claims 

totaling approximately $211,308.46 to Adarna for defendant Dr. Castor’s home health 

care referrals.

Amore Home Health Care Services, Inc.

60. Amore was engaged in business as a Medicare provider of home health services in Lake 

County, Indiana from March 14, 2011 through December 31, 2013.

61. From March 14, 2011 through December 31, 2013, Debbie J. Castor was the President

and sole shareholder of Amore until she sold the business on December 31, 2013.

62. From March 14, 2011 through December 31, 2013, Debbie J. Castor was the sister-in-law 

of defendant Dr. Castor and the wife of Johnny Castor, one of defendant Dr. Castor’s 

brothers.

63. Defendant Dr. Castor knowingly referred his patients to Amore to receive home health 

services in violation of the Stark Law and 42 C.F.R. § 424.22.

64. Amore and Debbie J. Castor submitted claims to Medicare for home health services for 

patients referred by defendant Dr. Castor in violation of the Stark Law and 42 C.F.R. 

§ 424.22.

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65. Attached as Exhibit 1E and here incorporated by reference as if set out in full, is a list of 

claims paid by Medicare to Amore for defendant Dr. Castor’s home health care referrals 

for the period from March 14, 2011 through January 25, 2014 (with patient names and 

other identifying information redacted pursuant to Fed. R. Civ. P. 5.2).

66. From March 14, 2011 through January 25, 2014, Medicare paid approximately 72 claims 

totaling approximately $180,471.14 to Amore for defendant Dr. Castor’s home health 

care referrals.

VIOLATIONS OF LAW

COUNT 1

False Claims Act: Presentation of False Claims

(31 U.S.C. § 3729(a)(1)(A))

67. Plaintiff United States realleges paragraphs 1 through 66 above as if fully set forth.

68. Defendant Dr. Castor, knowingly presented, or caused to be presented, approximately 

472 false or fraudulent claims to Medicare for defendant Dr. Castor’s home health care 

referrals to defendant American, Adarna, and Amore.

69. Defendant American, knowingly presented, or caused to be presented, approximately 

318 false or fraudulent claims to Medicare for defendant Dr. Castor’s home health care 

referrals to American.

70. Defendant Duncan, knowingly presented, or caused to be presented, approximately 

318 false or fraudulent claims to Medicare from defendant American for defendant

Dr. Castor’s home health care referrals to American.

71. Defendant Jacob Castor, knowingly presented, or caused to be presented, approximately 

17 false or fraudulent claims to Medicare from defendant American for defendant

Dr. Castor’s home health care referrals to American.

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72. The false or fraudulent information in each claim was material to Medicare’s decision to 

pay the false claims that defendant American, defendant Duncan, defendant Jacob Castor, 

Adarna, and Amore submitted to Medicare.

73. Defendants Dr. Castor, American, Duncan, and Jacob Castor presented the false or 

fraudulent claims to Medicare, or caused the false or fraudulent claims to be presented to 

Medicare, with actual knowledge of their falsity, or with reckless disregard or deliberate 

ignorance of whether or not they were false.

74. Plaintiff United States sustained a loss from the false or fraudulent claims defendant

American, defendant Duncan, defendant Jacob Castor, Adarna, and Amore submitted to 

Medicare.

75. Defendants Dr. Castor, American, Duncan, and Jacob Castor are liable to plaintiff United 

States under the FCA, jointly and severally, for three times the loss sustained by plaintiff 

United States plus a civil penalty of not less than $5,500 and not more than $11,000 per 

false claim and the costs of this civil action brought to recover such penalty and damages. 

31 U.S.C. § 3729(a)(1), (3). Federal Civil Penalties Inflation Adjustment Act of 1990, 

28 U.S.C. § 2461 note; Public Law 101-410; 64 Fed. Reg. 47,099, 47,103 (1999).

COUNT 2

False Claims Act: False Statements Material to False Claims

(31 U.S.C. § 3729(a)(1)(B))

76. Plaintiff United States realleges paragraphs 1 through 75 above as if fully set forth.

77. Defendant Dr. Castor knowingly made, used, or caused to be made or used, false or

fraudulent records or statements, including claims for payment or approval submitted to 

Medicare (identified in paragraphs 31-62 above) for DHS rendered to patients by an 

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entity owned by the referring physician’s immediate family members in violation of the 

Stark Law.

78. Defendant American knowingly made, used, or caused to be made or used, false or

fraudulent records or statements, including claims for payment or approval submitted to 

the United States (identified in paragraphs 31-48 above) for DHS rendered to patients by 

an entity owned by the referring physician’s immediate family members in violation of 

the Stark Law.

79. Defendant Duncan knowingly made, used, or caused to be made or used, false or

fraudulent records or statements, including claims for payment or approval submitted to 

the United States (identified in paragraphs 31-48 above) for DHS rendered to patients by 

an entity owned by the referring physician’s immediate family members in violation of 

the Stark Law.

80. Defendant Jacob Castor knowingly made, used, or caused to be made or used, false or

fraudulent records or statements, including claims for payment or approval submitted to 

the United States (identified in paragraphs 31-48 above) for DHS rendered to patients by 

an entity owned by the referring physician’s immediate family members in violation of 

the Stark Law.

81. The false or fraudulent records or statements that defendants Dr. Castor, American, 

Duncan, and Jacob Castor made, used, or caused to be made or used were material to the 

decisions of Medicare to pay the false claims that those defendants submitted, or caused 

to be submitted, to Medicare.

82. Defendants Dr. Castor, American, Duncan, and Jacob Castor made, used, or caused to be 

made or used, the false or fraudulent records or statements with actual knowledge of their 

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falsity, or with reckless disregard or deliberate ignorance of whether or not they were 

false.

83. Plaintiff United States sustained a loss from the false or fraudulent claims to Medicare 

that defendants Dr. Castor, American, Duncan, and Jacob Castor caused to be submitted 

using false or fraudulent records or statements that defendants Dr. Castor, American, 

Duncan, and Jacob Castor made, used, or caused to be made or used.

84. Defendants Dr. Castor, American, Duncan, and Jacob Castor are liable to the United 

States under the FCA, jointly and severally, for three times the loss sustained by the 

United States plus a civil penalty of not less than $5,500 and not more than $11,000 per 

false claim and the costs of this civil action brought to recover such penalty and damages. 

31 U.S.C. § 3729(a)(1), (3). Federal Civil Penalties Inflation Adjustment Act of 1990, 

28 U.S.C. § 2461 note; Public Law 101-410; 64 Fed. Reg. 47,099, 47,103 (1999).

COUNT 3 (Defendants American, Duncan, and Jacob Castor)

Payment by Mistake

85. Plaintiff United States realleges paragraphs 1 through 84 above as if fully set forth.

86. This is a claim for the recovery of monies paid by Medicare to defendants American, 

Duncan, and Jacob Castor because of mistaken understandings of fact.

87. Defendants American, Duncan, and Jacob Castor were not entitled to receive payment 

from the United States for DHS furnished by an entity that had a “financial relationship” 

with the referring physician or an “immediate family member” of such physician as 

prohibited by the Stark Law.

88. The United States paid defendants American, Duncan, and Jacob Castor for claims for 

DHS, specifically home health services, furnished by an entity that had a “financial 

relationship” with an “immediate family member” of the referring physician without 

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knowledge of material facts, and under the mistaken belief that defendants American, 

Duncan, and Jacob Castor were entitled to receive payment for such claims. 

89. The United States’ mistaken belief was material to its decision to pay claims for home 

health services submitted, or caused to be submitted, by defendants American, Duncan, 

and Jacob Castor.

90. Plaintiff United States suffered losses as a result of the Medicare payments to defendants

American, Duncan, and Jacob Castor based on a mistake of fact.

91. Defendants American, Duncan, and Jacob Castor are liable to account and pay to plaintiff 

United States the payments that Medicare made in error to defendants American, Duncan, 

and Jacob Castor.

COUNT 4 (Defendants American, Duncan, and Jacob Castor)

Unjust Enrichment

92. Plaintiff United States realleges paragraphs 1 through 91 above as if fully set forth.

93. This is a claim by plaintiff United States for recovery of monies by which defendants

American, Duncan, and Jacob Castor were unjustly enriched.

94. By obtaining Medicare funds, directly or indirectly, to which they were not entitled, 

defendants American, Duncan, and Jacob Castor were unjustly enriched.

95. Plaintiff United States suffered losses because of the unjust enrichment of defendants

American, Duncan, and Jacob Castor.

96. Defendants American, Duncan, and Jacob Castor are liable to account and pay to plaintiff

United States the amounts defendants American, Duncan, and Jacob Castor received 

from Medicare to which they were not entitled.

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REQUEST FOR RELIEF

WHEREFORE, plaintiff United States of America requests that this Court enter judgment 

in its favor against defendants Conrado Castor, M.D., American Home Health Services, Inc., 

Aurea Duncan, and Jacob Castor, jointly and severally, as follows:

1. For Counts 1 and 2 under the False Claims Act, the amount of plaintiff United States’ 

damages, trebled as required by law, and such civil penalties as are authorized by law.

2. For Counts 3 and 4 for payment by mistake and unjust enrichment, the damages sustained 

or the amounts by which defendants American, Duncan, and Jacob Castor were paid by 

mistake or unjustly enriched, or by which defendants American, Duncan, and Jacob 

Castor retained monies to which they were not entitled, plus pre-judgment interest, 

attorneys’ fees, costs, and expenses.

3. The costs of this action.

4. All additional and other relief that is just and proper.

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JURY DEMAND

Plaintiff United States of America demands a jury trial on all issues so triable.

Respectfully submitted,

THOMAS L. KIRSCH II

UNITED STATES ATTORNEY

/s/ Wayne T. Ault

WAYNE T. AULT

DIRK D. DE LOR

Assistant United States Attorneys

Northern District of Indiana

5400 Federal Plaza, Suite 1500

Hammond, Indiana 46320

Telephone: 219-937-5500

Telecopy: 219-852-2770

Internet Address: Wayne.Ault@usdoj.gov

Counsel for Plaintiff United States of America

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