What You Need to Know About Hospice Medicare Fraud

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.

What is Hospice Fraud?

Hospice fraud occurs when a hospice acts with only the hospice’s profit-making interests in mind and with complete disregard of the patient’s diagnosis or medical condition. Below is list of hospice fraud schemes to look out for:

  • A hospice provider offers hospice care to a patient who has not been diagnosed as terminally ill by a physician
  • A hospice provider bribes a patient with gifts in order to convince him or her to receive hospice care
  • A hospice provider exaggerates the severity of a patient’s condition and the care he or she requires in order to receive a higher amount of reimbursement
  • A hospice provider orders excessive or unnecessary medical equipment for a patient
  • A hospice provider pays a physician or other healthcare provider monetary value or gifts in exchange for referrals
  • A hospice provider bills for unnecessary medical tests and treatment or for a higher level of medical testing and treatment than what is necessary
  • A hospice provider forges a physician’s signature or falsifies a physician document certifying hospice care for a patient
  • A hospice provider bills for the services a patient needs but does not actually provide the service, in part or in whole
  • A hospice provider keeps a patient whose health is improving rather than declining
  • A hospice provider keeps a patient for long periods of time without any medical justification to do so

Contact a Santa Rosa or San Francisco Whistleblower Attorney Today

If you believe you have witnessed hospice fraud involving any of the hospice fraud schemes outlined above, contact the whistleblower attorneys at Willoughby Brod to report your claim or learn about your options for next steps. Our attorneys have successfully helped countless whistleblowers come forth with their claims relating to hospice fraud schemes. Contact us online or at (800) 427-7020 today for a free consultation.

(image courtesy of James Williams)