Guardian Health Care Inc., Gem City Home Care LLC, and Care Connection of Cincinnati LLC, home health agencies operating in Texas, Ohio, and Indiana, along with their owner Evolution Health LLC (collectively referred to as the Companies), have agreed to pay $4,496,330 to resolve allegations that they violated the False Claims Act by knowingly providing illegal kickbacks to assisted living facilities and physicians in exchange for Medicare referrals.
This settlement addresses allegations that from 2013 to 2022, Guardian Health Care, Gem City Home Care, and Care Connection of Cincinnati provided lease payments and other valuable benefits—including wellness health services, sports tickets, and meals—to numerous assisted living facilities and their residents as well as certain healthcare providers. These benefits were allegedly given in exchange for referrals of Medicare beneficiaries. The home health agencies then billed Medicare for the home health services provided to these referred patients.
The Anti-Kickback Statute prohibits offering remuneration with the intent to induce referrals of government healthcare program business. This statute aims to ensure that medical providers' judgments are not influenced by improper financial incentives. Claims knowingly submitted in violation of the Anti-Kickback Statute are ineligible for payment and can violate the False Claims Act.
“It is imperative to ensure that improper financial incentives play no role in decisions regarding patient care,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Today’s resolution demonstrates the department’s commitment to protecting the integrity of federal healthcare programs and the medical treatment received by their beneficiaries.”
The Companies received credit under departmental guidelines for taking disclosure, cooperation, and remediation into account in False Claims Act cases. Among other actions, they disclosed the conduct to the government, identified individuals involved, and assisted in determining losses caused to Medicare.
The investigation and resolution highlight the government's focus on combating healthcare fraud using tools like the False Claims Act. Tips about potential fraud can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).
Trial Attorney Elizabeth A. Strawn from the Civil Division’s Commercial Litigation Branch Fraud Section and Assistant U.S. Attorney Brandi Stewart for the Southern District of Ohio handled this matter.
The claims resolved by this settlement are allegations only; there has been no determination of liability.
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