Watermark Retirement Communities LLC, a senior living community operator based in Tucson, Arizona, that manages 79 retirement homes across the country, agreed to pay $4.25 million to resolve allegations that it violated the False Claims Act by soliciting and receiving a kickback from a nationwide home health agency (HHA) operator in order to facilitate referrals from Watermark retirement homes.
The United States alleged that the HHA operator purchased two of Watermark’s HHAs in Arizona to induce referrals of Medicare beneficiaries living in Watermark residential communities. The scheme was designed around eight Watermark retirement homes in five states (Arizona, Connecticut, Delaware, Florida and Pennsylvania) where the two companies had overlapping operations. The United States alleged that from Jan. 1, 2014 through Oct. 31, 2020, Watermark caused the HHA operator to submit false claims for payments to Medicare for services provided to Medicare beneficiaries referred as a result of the kickback transaction. The Antikickback Statute prohibits parties who participate in federal health care programs from knowingly and willfully soliciting or receiving any remuneration in return for referring an individual to, or arranging for the furnishing of any item or services for which payment is made by, a federal health care program.
“It is imperative that decisions about the care provided to federal health care beneficiaries are not undermined by the payment of kickbacks,” said Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division. “Today’s resolution demonstrates that the Department is committed to holding accountable not only those who offer kickbacks but also those who receive them.”
“Whether you pay them or receive them, kickbacks undermine the integrity of our health care system,” said U.S. Philip R. Attorney Sellinger for the District of New Jersey. “Patients need to know the health care referrals they receive are in their best interest, not in the best interest of someone else’s bottom line. Our office will always be on guard to prevent unscrupulous operators from trying to take financial advantage of our health care system.”
The settlement announced today includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act by David Freedman, who was the former director of strategic growth for the HHA operator between 2009 and 2016. The qui tam provisions permit a private party to file an action on behalf of the United States and receive a portion of any recovery. As part of today’s resolution with Watermark, Freedman will receive approximately $765,000. In September 2021, the HHA operator entered into a settlement with the United States to resolve the claims against it arising out of the same transaction. See www.justice.gov/opa/pr/home-health-agency-operator-bayada-pay-17-million-resolve-false-claims-act-allegations-paying.
The resolution obtained in this matter was the result of a coordinated effort between the Justice Department’s Civil Division, Commercial Litigation Branch, Fraud Section and the U.S. Attorney’s Office for the District of New Jersey, with assistance from the Department of Health and Human Services Office of Inspector General.
The investigation and resolution of this matter illustrates the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse, and mismanagement, can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).
The matter was handled by Trial Attorneys Samson Asiyanbi and Daniel Meyler of the Civil Division’s Fraud Section and Assistant U.S. Attorney Jordann Conaboy for the District of New Jersey.
The case is docketed as United States ex rel. Freedman v. Bayada Home Health Care, Inc., Civ. No. 17-6267 (D.N.J.).
The claims resolved by the settlement are allegations only and there has been no determination of liability.
Official news published at https://www.justice.gov/opa/pr/watermark-retirement-communities-pay-425-million-allegedly-receiving-kickback-violation
