Home Health Providers to Pay $4.5M to Settle False Claims Act Allegations

Three home health agencies and their parent company have agreed to pay $4.5 million to settle allegations of violating the False Claims Act. The U.S. Department of Justice announced on Monday, July 1, 2024, that Guardian Health Care Inc., Gem City Home Care LLC, Care Connection of Cincinnati LLC, and their owner Evolution Health LLC have reached this agreement to resolve claims of providing illegal kickbacks for Medicare referrals.

The settlement addresses allegations spanning from 2013 to 2022, during which these companies, operating in Texas, Ohio, and Indiana, allegedly offered various forms of remuneration to assisted living facilities and physicians. These inducements reportedly included lease payments, wellness health services, sports tickets, and meals, all provided in exchange for referrals of Medicare beneficiaries.

According to the Justice Department, the home health agencies subsequently billed Medicare for services provided to these referred patients, violating the Anti-Kickback Statute. This federal law prohibits the exchange of anything of value to induce referrals for services that may be paid for by federal healthcare programs.

Principal Deputy Assistant Attorney General Brian M. Boynton emphasized the importance of this settlement, stating, "It is imperative to ensure that improper financial incentives play no role in decisions regarding patient care." He added that this resolution demonstrates the department's commitment to protecting the integrity of federal health care programs and the medical treatment received by their beneficiaries.

Notably, the companies received credit under the department's guidelines for their cooperation, including self-disclosure of the conduct, identification of involved individuals, and assistance in determining losses to Medicare.

This case highlights the ongoing efforts of the U.S. government to combat healthcare fraud, with the False Claims Act serving as a powerful tool in this endeavor. The Department of Health and Human Services continues to encourage tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement.

While the settlement resolves these allegations, it's important to note that there has been no determination of liability, and the claims remain allegations only.

This case was handled by the Civil Division's Commercial Litigation Branch, Fraud Section, and the U.S. Attorney's Office for the Southern District of Ohio, underscoring the collaborative efforts in addressing healthcare fraud at both federal and local levels.

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