We represent victims of reverse discrimination and anti-DEI whistleblowers

When someone’s medical condition is serious enough that they require assistance at home, patients and their families typically place a great deal of trust in the recommendations made by doctors. If the individual is going back to their residence from an assisted living facility, they might also turn to the professionals at the facility for advice on selecting a home health provider. Given the seriousness of these situations, these recommendations should be based purely on what is best for the patient who requires help. 

Unfortunately, a Department of Justice investigation found that an Ohio company used kickbacks and other illegal inducements to secure Medicare referrals from doctors and facilities. As a result, Guardian Health Care Inc., Gem City Home Care LLC, Care Connection of Cincinnati LLC and their parent company Evolution Health LLC will pay $4,496,330 to settle allegations of violating the False Claims Act.

According to a DOJ press release, Evolution’s companies made lease payments and provided other valuable benefits to numerous assisted living facilities and healthcare providers over a period of approximately 10 years. Other inducements included wellness health services, tickets to sporting events and free meals to assisted living facilities and their residents. These incentives were given in exchange for referrals of Medicare beneficiaries to the Companies for home health services. Following these referrals, the home health agencies billed Medicare for the services provided to the referred patients. By doing so, the Companies not only violated the Anti-Kickback Statute but also submitted false claims to Medicare, contravening the False Claims Act.

The Anti-Kickback Statute prohibits offering, paying, soliciting or receiving any remuneration to entice referrals of services covered by federally funded programs like Medicare. Violations can lead to severe penalties, including substantial fines and exclusion from federal healthcare programs. Individuals and companies who defraud governmental programs are also in violation of the False Claims Act. By billing Medicare for services provided through illegal referrals, the Companies submitted false claims.

There is a high incidence of Medicare and Medicaid fraud throughout the United States, and this type of illegality takes on many forms. Home health services can be particularly prone to misrepresentation by dishonest providers and other types of malfeasance, such as the kickbacks in the Evolution case. Frequently, this misconduct goes undetected unless an employee steps up to report the unlawful acts. 

At Kardell Law Group, we represent whistleblowers who report medical fraud cases and other impropriety that they observe while on the job. Our firm safeguards’ clients’ rights and represents them in qui tam lawsuits where they might collect payment for citing fraud against the government.