Articles Tagged with hospice care fraud law firm

james-williams-502481-unsplash-copy-300x225There is no such thing as “good” fraud, but on the hierarchy of Medicare fraud from bad to worst, hospice fraud is arguably one of the most despicable types. Medicare Part A covers hospice care for patients who are “terminally ill,” or have a life expectancy of six months or less. If you believe you have witnessed hospice fraud, make it your duty to report the fraud and honor an individual’s last moments in this world. The whistleblower attorneys at Willoughby Brod are experienced at helping whistleblowers bring their claims forward and protecting them in the process. Contact us today for a free consultation and to learn how we can help.

What Does Medicare Provide by Way of Hospice Care?

As mentioned above, Medicare Part A covers hospice care for patients who are deemed by a medical professional to be terminally ill, which is defined as having a life expectancy of six months or less. Medicare covers only hospice care for terminally ill patients and not any curative treatments, although hospice patients can continue to receive curative care coverage for conditions unrelated to the cause of their terminal illness.

Anyone who hhospicehandsas ever watched a loved one fight through the final stages of a terminal illness knows how important kindness is during these times.  Some of the kindest and most caring people in the world work with terminal patients and their families in hospice care settings.  On behalf of everyone these people touch, we want to say thank you.  It is because we respect these workers so much and understand the importance of their work that we are particularly angered by the allegations in a recent false claims act case accusing a health care provider of hospice care fraud.  This case is a reminder of the very profound real world impact of health care fraud and it is one example of why we choose to serve as a health care fraud whistleblowers’ law firm.

Hospice Provider to Pay $18 Million to Settle Medicare Fraud Allegations

On July 13, the Department of Justice (“DOJ”) issued a press release announcing that a hospice care provider has agreed to pay $18 million to settle pending allegations of False Claims Act violations.  The defendant, Evercare Hospice and Palliative Care (“Evercare”), now known as Optum Palliative and Hospice Care, is based in Minnesota and provides hospice care in several different states.  As the DOJ explains, hospice care is a special form of care aimed at providing comfort to the terminally ill.  Hospice care patients receive palliative care only and do not receive medical care aimed at treating their illnesses.  Medicare only allows patients with a life expectancy of six months or less to receive coverage for hospice care.

hospicehandsHospice care workers are some of the most amazing people you’ll ever encounter.  Not only do they care for people in their final days, they also care for the patient’s families.  All forms of Medicare fraud result in theft of taxpayer’s money and endanger the health of beneficiaries, but there’s something particularly insidious about hospice fraud.  Our Medicare fraud attorney is honored to work with private individuals who observe these wrongs and step forward to help stop them.

FBI Reports on Case of Hospice Fraud

Last week, the FBI posted a report dealing with a case of hospice care fraud in Oklahoma (note: all assertions in this post regarding the case are per the FBI’s report).  P.K. owned a hospice center and, together with certain colleagues, submitted fraudulent claims to Medicare totaling in the millions of dollars.  From June 2010 to July 2013, the conspirators did not comply with the rules and regulations governing Medicare-eligible hospice centers.  They actively concealed the actual health status of patients and falsely reported the treatment provided, including claiming nurse visits that never actually occurred and altering files to make patients appear sicker than they actually were.  While hospice is intended for the terminally ill, specifically patients with a life expectancy of six months or less, many patients remained at the center for five to seven years.  When an audit was performed to review services in the state, P.K. provided falsified documents to those conducting the audit.