Feds: Nursing home firm to pay $15.4 million in billing case

BROCKWAY (AP) — A Pennsylvania-based nursing home company has agreed to pay more than $15.4 million to resolve allegations of overbilling for medically unnecessary rehabilitation therapy services, federal authorities said Wednesday.

The Department of Justice said the False Claims Act allegations involved overbilling Medicare and the Federal Employees Health Benefits Program from 2011 through 2017.

The company was accused of having had facilities in Pennsylvania, West Virginia, and Ohio 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,” federal authorities said.

Two former Guardian employees who brought the allegations are to receive approximately $2.8 million, the department said.

Brockway, Pennsylvania-based Guardian, which operates more than 50 nursing facilities in Pennsylvania, Ohio and West Virginia, said resident care “remains our first priority and we are committed to meeting our obligations under this agreement.

“We are confident that Guardian’s corporate compliance program advocates for our patients, their families and caregivers,” Patricia McGillan, the company’s chief compliance officer, said in a statement.