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IN THE UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF INDIANA

HAMMOND DIVISION

UNITED STATES OF AMERICA, ex. rel. )

BRADLEY A. STEPHENS, Relator, )

)

Plaintiff, )

)

vs. ) No. 2:13CV145

)

CONRADO CASTOR, M.D., AMERICAN HOME )

HEALTH SERVICES, INC., AUREA DUNCAN, AND )

JACOB CASTOR, )

)

Defendants. )

DEFENDANT CONRADO CASTOR, M.D.’S ANSWER TO PLAINTIFF’S

COMPLAINT AND AFFIRMATIVE DEFENSES

Defendant, Conrado Castor, M.D. (“Castor”), by counsel, for his Answer to Plaintiff’s

Complaint filed herein, states:

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.

ANSWER: Castor admits that Plaintiff’s Complaint purports to state claims for 

damages and civil penalties under the False Claims Act, fraud, unjust enrichment 

and payment by mistake of fact, but denies any liability on those claims.

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).

ANSWER: Castor neither admits nor denies the allegations contained in rhetorical 

paragraph 2 because he lacks sufficient knowledge as to their truth or falsity.

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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 were 

owned by 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.

ANSWER: Castor admits Aurea Duncan and Jacob Castor are his siblings, but denies 

the remaining allegations contained in rhetorical paragraph 3.

JURISDICTION AND VENUE

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

and 38 U.S.C. §§ 1345 and 1367(a).

ANSWER: Without admitting to the allegations contained in the Complaint, Castor 

admits this Court has jurisdiction over the subject matter of the Complaint.

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.

ANSWER: Without admitting to the allegations contained in the Complaint, Castor 

admits that venue is proper in the Northern District of Indiana.

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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).

ANSWER: Because no allegations are made against Castor, he does not respond to the 

allegations in rhetorical paragraph 6. To the extent a response is necessary, Castor 

denies said allegations.

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

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 7 

and therefore denies same.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 8 

and therefore denies same.

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.

ANSWER: Castor admits he resides in Schererville, Indiana and that he was a physician 

during the time frame relevant to the allegations of the Complaint. Castor admits 

part of his business involved Medicare, but denies all other allegations.

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.

ANSWER: Castor admits American was a home health provider, but denies all other 

allegations.

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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.

ANSWER: Castor admits Duncan is his sister and that she resides in Crown Point, 

Indiana, but he is without knowledge as to the remaining allegations and therefore 

denies same.

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.

ANSWER: Castor admits Jacob Castor is his brother and that he resides in Munster, 

Indiana, but he is without knowledge as to the remaining allegations and therefore 

denies same.

THE LAW

The False Claim 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).

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required, Castor denies the 

allegations.

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;

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(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 or property to the 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 or not less than $5,500 and not more 

than $11,000, 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) means 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).

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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

§ 3731(d).

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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The Stark Law

16. The physician self-referral law, 41 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 the overutilization of DHS, increased costs, and corruption of medical judgment.

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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).

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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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).

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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

See 42 C.F.R. § 411.351.

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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)(1). See also Omnibus Reconciliation Act of 

1993, P.L. 103-66, § 13562, Social Security Act Amendments of 1994, P.L. 103-432, § 152.

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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).

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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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ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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).

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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),

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint contain 

generalized statements regarding various aspects of the law to which an answer is 

not required. To the extent an answer is required Castor denies the allegations.

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

accomplished through CMS.

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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.

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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27. To participate in the Medicare program as a new enrollee, physicians and nonphysician practitioners must submit a Medicare Enrollment Application, CMS Form-8551. 

Physicians also submit Form-8551 if they are reactivating or revalidating Medicare enrollment or 

changing certain enrollment information.

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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).

When a physician signs the certification statement contained in Form CMS-8551, 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.

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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.

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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 

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

and the “referring provider or other source.”

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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.

ANSWER: Castor admits the allegations contained in rhetorical paragraph 31 as to 

himself, but he is without knowledge as to the other defendants and therefore denies 

any allegation related to those defendants.

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 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.

ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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.

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ANSWER: The allegations contained in this rhetorical paragraph of the Complaint 

contain generalized statements regarding various aspects of the law to which an 

answer is not required. To the extent an answer is required Castor denies the 

allegations.

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 America, 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.

ANSWER: Castor denies the allegations in rhetorical paragraph 34.

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.

ANSWER: Castor denies the allegations in rhetorical paragraph 35.

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

owned by defendant Dr. Castor’s immediate family members.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 36 

and therefore denies same.

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.

ANSWER: Castor denies the allegations in rhetorical paragraph 37.

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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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 38 

and therefore denies same.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 39 

and therefore denies same.

America 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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 40 

and therefore denies same.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 41 

and therefore denies same.

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

ANSWER: Castor admits the allegations in rhetorical paragraph 42.

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.

ANSWER: Castor denies the allegations contained in rhetorical paragraph 43.

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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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 44 

and therefore denies same.

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.

ANSWER: Castor denies the allegations contained in rhetorical paragraph 46.

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. 52).

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 46 

and therefore denies same.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 47 

and therefore denies same.

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

until August 2008.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 48 

and therefore denies same.

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

ANSWER: Castor admits the allegations in rhetorical paragraph 49.

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

his ownership in defendant American, defendant Jacob Castor knowingly 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.

ANSWER: Castor denies the allegations in rhetorical paragraph 50.

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).

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 48 

and therefore denies same.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 52 

and therefore denies same.

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 and 

at least January 13, 2014.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 53 

and therefore denies same.

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

was Adarna;s Chief Executive officer and Owner.

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ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

54 and therefore denies same.

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

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

ANSWER: Castor admits the allegations in rhetorical paragraph 55.

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

Stark law to receive home health services.

ANSWER: Castor denies the allegations in rhetorical paragraph 56.

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 July 

22, 2008 through at least January 13, 2014, in violation of the Stark Law and 42 C.F.R. § 424.22.

ANSWER: Castor denies the allegations contained in rhetorical paragraph 57.

58. Attached as Exhibit 1D and here incorporated 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).

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

58 and therefore denies same.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

59 and therefore denies same.

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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 13, 2013.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

60 and therefore denies same.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

61 and therefore denies same.

62. From March 14, 2011 through December 31, 2013, Debbie J. Castor was the sisterin-law of defendant Castor and the wife of Johnny Castor, one of defendant Dr. Castor’s brothers.

ANSWER: Castor admits the allegations in rhetorical paragraph 62.

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.

ANSWER: Castor denies the allegations in rhetorical paragraph 63.

64. Amore and Debbie J. Astor 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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

64 and therefore denies same.

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).

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

65 and therefore denies same.

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

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

referrals.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

66 and therefore denies same.

VIOLATIONS OF LAW

COUNT I

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

ANSWER: Castor realleges his answers to rhetorical paragraphs 1 through 66 of his 

answer as if fully set forth herein.

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.

ANSWER: Castor denies the allegations in rhetorical paragraph 68.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

69 and therefore denies same.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

70 and therefore denies same.

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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. Castro’s home health care referrals to American.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

71 and therefore denies same.

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.

ANSWER: Castor denies the allegations in rhetorical paragraph 72.

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.

ANSWER: Castor denies the allegations in rhetorical paragraph 73.

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.

ANSWER: Castor denies the allegations in rhetorical paragraph 74.

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)..

ANSWER: Castor denies the allegations in rhetorical paragraph 75.

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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.

ANSWER: Castor realleges his answers to rhetorical paragraphs 1 through 75 of his 

answer as if fully set forth herein.

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 entity owned 

by the referring physician’s immediate family members in violation of the Stark Law.

ANSWER: Castor denies the allegations in rhetorical paragraph 77.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

78 and therefore denies same.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

79 and therefore denies same.

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.

ANSWER: Castor is without knowledge as to the allegations in rhetorical paragraph 

80 and therefore denies same.

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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.

ANSWER: Castor denies the allegations in rhetorical paragraph 81.

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 

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

ANSWER: Castor denies the allegations in rhetorical paragraph 82.

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.

ANSWER: Castor denies the allegations in rhetorical paragraph 83.

84. Defendants Dr. Castor, American, Duncan, and Jacob Castor are liable t 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).

ANSWER: Castor denies the allegations in rhetorical paragraph 84.

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.

ANSWER: No answer is necessary because no claim is stated against Castor in Count 

3.

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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.

ANSWER: No answer is necessary because no claim is stated against Castor in Count 

3.

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.

ANSWER: No answer is necessary because no claim is stated against Castor in Count 

3.

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 knowledge 

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

Castor were entitled to receive payment for such claims.

ANSWER: No answer is necessary because no claim is stated against Castor in Count 

3.

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.

ANSWER: No answer is necessary because no claim is stated against Castor in Count 

3.

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.

ANSWER: No answer is necessary because no claim is stated against Castor in Count 

3.

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.

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ANSWER: No answer is necessary because no claim is stated against Castor in Count 

3.

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.

ANSEWR: No answer is necessary because no claim is stated against Castor in Count 

4.

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

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

ANSWER: No answer is necessary because no claim is stated against Castor in Count 

4.

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

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

ANSWER: No answer is necessary because no claim is stated against Castor in Count 

4.

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

defendants American, Duncan, and Jacob Castor.

ANSWER: No answer is necessary because no claim is stated against Castor in Count 

4.

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

plaintiff United States the amounts defendants America, Duncan, and Jacob Castor received from 

Medicare to which they were not entitled.

ANSWER: No answer is necessary because no claim is stated against Castor in Count 

4.

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WHEREFORE, Defendant, Conrado Castor, M.D., by counsel, prays that Plaintiff take 

nothing by its Complaint, for costs of this action, and for all other just and proper relief in the 

premises.

JURY DEMAND

Defendant, Conrado Castor, M.D., by counsel, requests trial by jury herein.

AFFIRMATIVE DEFENSES

Defendant, Conrado Castor, M.D., for his Affirmative Defenses to the Plaintiff’s 

Complaint, states:

1. That the Complaint fails to state a claim upon which relief can be granted.

2. That if it should be deemed that Defendant has failed to answer any allegations 

contained in the Plaintiff’s Complaint, Defendant hereby denies said allegation.

3. The claims of Plaintiff against Defendant, Dr. Conrado Castor, are barred by the 

statute of limitations.

4. Any and all home healthcare services performed by Defendant American Home 

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

Services, Inc., their agents and employees were medically necessary.

5. The referrals in question were not made by Dr. Conrado Castor in all instances and 

he therefore should not be liable to Plaintiff for those referrals..

6. Defendant reserves the right to add any additional affirmative defenses which 

become known to him in the future,

WHEREFORE, Defendant, Conrado Castor, M.D., respectfully requests that Plaintiff take 

nothing by way of its Complaint, for costs of this action, and for all other just and proper relief in 

the premises.

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Respectfully submitted,

BURKE COSTANZA & CARBERRY LLP

Attorneys for Defendant, 

Conrado Castor, M.D.

By: /s/Kevin E. Steele____________

Kevin E. Steele, #17567-53

156 S. Washington Street

Valparaiso, IN 46383

PH: (219) 531-0134

steele@bcclegal.com

CERTIFICATE OF SERVICE

I hereby certify that on March 5, 2020, I electronically filed the foregoing with the Clerk 

of the Court using the CM/ECF system which sent notification of such filing to the following:

Wayne T. Ault

Assistant United States Attorneys

Northern District of Indiana

5400 Federal Plaza, Suite 1500

Hammond, IN 46320

PH: (219) 937-5500

Wayne.Ault@usdoj.gov

Fred W. Grady

Fred W. Grady, P.C.

Harris Bank Building – Suite One

750 S. Washington Street

Valparaiso, IN 46383

fwgpclaw@gmail.com

By: /s/Kevin E. Steele____________

Kevin E. Steele, #17567-53

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