Nursing home company to pay $15.4M in overbilling case

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HARRISBURG, Pa. (WHTM) – A Pennsylvania-based company that operates more than 50 nursing homes and independent living facilities has agreed to pay $15.4 million to resolve allegations it knowingly overbilled for medically unnecessary rehabilitation therapy services.

The Department of Justice announced the settlement Wednesday with Guardian Elder Care Holdings and its related companies.

Authorities said from January 2011 through December 2017, Guardian caused certain facilities to bill for patients at the highest level of Medicare reimbursement when services at that level were influenced by financial considerations rather than resident needs.

The settlement also resolves allegations voluntarily disclosed by Guardian that it employed two people who were excluded from federal healthcare programs. As a result, Guardian inappropriately received payment for ineligible services.

Guardian operates nursing facilities in Pennsylvania, Ohio and West Virginia. Local facilities are in Carlisle, Elizabethtown, Mifflintown and Lewistown.

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