by Ben Vernia | February 19th, 2020
On February 19, 2020, the Department of Justice announced that the nursing home company Guardian Elder Care Holdings, Inc., had agreed to pay over $15.4 million to resolve allegations, originally brought by two former employees in a whistleblower suit, that the company defrauded federal healthcare programs by submitting claims for medically unnecessary rehabilitation services. According to DOJ’s press release:
Guardian Elder Care Holdings Inc., and related companies Guardian LTC Management Inc., Guardian Elder Care Management Inc., Guardian Elder Care Management I Inc., and Guardian Rehabilitation Services Inc., (Guardian) agreed to pay $15,466,278 to resolve False Claims Act allegations that they knowingly overbilled Medicare and the Federal Employees Health Benefits Program for medically unnecessary rehabilitation therapy services, the Department of Justice announced today. Guardian operates more than 50 nursing facilities throughout Pennsylvania, as well as in Ohio and West Virginia.
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The settlement announced today resolve claims by the United States that from Jan. 1, 2011, through Dec. 31, 2017, Guardian caused certain facilities in Pennsylvania, West Virginia, and Ohio to bill for patients at the highest level of Medicare reimbursement, when services at that level were not medically necessary and were influenced by financial considerations rather than resident needs.
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The Government announced that the whistleblowers will receive $2.8 million (an 18% relators’ share).
