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Forty-six assisted living communities have been named as recipients of alleged illegal kickbacks that were the focus of a $4.5 million settlement reached between the federal government and a group of home health companies.

The Department of Justice announced the settlement settlement Monday. It includes $2.1 million in restitution from Guardian Health Care Inc., Gem City Home Care LLC and Care Connection of Cincinnati LLC, along with their owner, Evolution Health LLC, for providing kickbacks to staff members and residents of the assisted living communities and 15 healthcare providers in Indiana, Ohio and Texas.

The assisted living providers contacted by McKnight’s Senior Living said they were either unaware of the allegations or no longer own the communities named in the settlement. Assisted living residents, not the communities, generally are the ones hiring home health companies, they pointed out.

The settlement resolves allegations that between 2013 and 2022, the home health companies provided lease payments, wellness health services, sports tickets and meals to numerous assisted living communities and their residents, as well as to healthcare providers, in exchange for referrals of Medicare beneficiaries.

In 2022, just before Amedisys Inc. acquired Evolution Health, the home health companies disclosed to federal authorities that they had potentially violated the Anti-Kickback Statute, providing items of value to assisted living communities to operate wellness centers to induce referrals of residents. The home health companies stopped the conduct, preserved documents relevant to the case, filed a supplemental disclosure and cooperated with the government’s investigation, according to the Justice Department.

The home health companies received credit for those actions and agreed to cooperate with the continuing federal investigation into the individuals involved in the scheme and not covered by the settlement, the DOJ said.

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