Guardian Health Care Inc. / Gem City Home Care LLC / Care Connection of Cincinnati LLC (Evolution Health LLC)

Ohio, OH 2013--2022 Home Health / Home Care

DOJ OIG False Claims Illegal Kickbacks Kickbacks To Assisted Living Kickbacks To Physicians

Penalty

$4.5 million

Outcome

Three home health agencies and their parent Evolution Health LLC settled for $4,496,330 for providing illegal kickbacks to assisted living facilities and physicians in exchange for Medicare referrals.

Details

Guardian Health Care / Gem City / Care Connection (OH/TX/IN) — $4.5M Kickback Settlement

Outcome: Guardian Health Care Inc., Gem City Home Care LLC, Care Connection of Cincinnati LLC, and parent Evolution Health LLC settled for $4,496,330 for providing illegal kickbacks to assisted living facilities and physicians in exchange for Medicare home health referrals.

Evolution Health LLC, through its home health agency subsidiaries operating across Texas, Ohio, and Indiana, ran a systematic kickback program designed to generate Medicare referrals. The agencies "provided illegal kickbacks to assisted living facilities and physicians in exchange for Medicare referrals" — paying these referral sources through lease payments, wellness health services, sports tickets, meals, and other valuable benefits.

The dual kickback streams — to both assisted living facilities and physicians — reflect a comprehensive referral-generation strategy that targeted the two most significant sources of home health referrals: the facilities where Medicare-eligible patients live, and the physicians who write home health orders. The scheme ran from approximately 2013 to 2022.

The U.S. Department of Justice announced the $4,496,330 settlement.

Primary Source: Home Health Providers To Pay $4.5M To Resolve Alleged False Claims Act Liability For Providing Kickbacks To Assisted Living Facilities And Doctors

How Crucible Prevents This

Crucible's anti-kickback enforcement hooks would flag payments flowing from home health agencies to assisted living facilities and physicians; a compliance gate auditing all financial relationships with referral sources against Anti-Kickback safe harbors would catch lease payments, wellness services, and other inducements disguised as legitimate business arrangements.

Source: Home Health Providers To Pay $4.5M To Resolve Alleged False Claims Act Liability For Providing Kickbacks To Assisted Living Facilities And Doctors

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