Whistleblower Lawyer Comments on Surge in Hospice Fraud Cases

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Whistleblower lawyer from the national qui tam law firm Levy Phillips & Konigsberg LLP comments on a recent surge in the number of hospice fraud cases brought under the Federal False Claims Act.

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Whistleblower lawyers Alan Konigsberg & Theresa Vitello

Medicare’s hospice benefit is designed to serve a vulnerable population of terminal, cancer-stricken patients. Providers who doctor notes and submit false claims not only take advantage of our tax dollars but also the already weakened cancer sufferers.

Whistleblower lawyer Theresa A. Vitello from the national qui tam law firm Levy Phillips & Konigsberg LLP (“LPK”) has commented on a recent surge in the number of hospice fraud cases filed under the Federal False Claims Act, and urges whistleblowers to contact her firm to report false claims for Medicare’s hospice care benefit.

The Department of Justice (“DOJ”) has recently settled two cases – one against a small not-for-profit hospice provider, Hernando-Pasco Hospice, Inc. (“Hernando-Pasco”), resulting in a $1 million recovery*, and another against Hospice of Arizona, L.C. (“Hospice of Arizona”), yielding a $12 million recovery**.

In addition, in May, 2013, the DOJ filed a False Claims Act complaint against the largest for-profit hospice chain in the country, Vitas Hospice Services LLC (“Vitas”), a subsidiary of Chemed Corporation, based in Cincinnati, Ohio. The False Claims Act case against Vitas seeks the recovery of tens of millions of dollars plus treble damages***. All three cases were originally filed by whistleblowers under the qui tam provisions of the False Claims Act.

The whistleblower lawyer from LPK explained that hospice care is palliative treatment provided to terminal cancer patients in their last few months of life. To receive Medicare’s hospice benefit, a patient must agree to forego further medical treatment of his disease and allow it to run its normal course.

According to Attorney Vitello, hospice care is paid for by Medicare at different levels. In addition to palliative care, continuous home care, also known as “crisis care,” is available to patients who are experiencing acute medical symptoms, which result in a brief period of crisis, requiring skilled nursing services on a short-term basis. It differs from the standard hospice benefit, which does not require skilled care. Crisis care allows the patient to receive more emergent care in the comfort of his home. Due to its nature, crisis care is the most expensive hospice benefit provided by Medicare, says Vitello.

In the case against Vitas, the Government has alleged that the hospice care center knowingly submitted false claims to Medicare for crisis care services that were not necessary, not actually provided, or not performed in accordance with Medicare requirements. According to the DOJ complaint, some of the egregious acts committed by Vitas include billing Medicare for one “crisis care” patient whose medical records indicated that she was playing bingo at the time and, another patient who was noted to be “very healthy given her age.”

The lawsuit against Hospice of Arizona and Tampa-based Hernando-Pasco alleged that the false claims emanated from the hospice providers’ submission of claims for patients who were ineligible or no longer appropriate for hospice care. According to the respective complaints, both providers actively pressured staff to find patients to enroll and to meet targets. They were also alleged to have delayed discharging patients from hospice and instructed staff to write false and misleading progress notes in order to keep patients on hospice longer than medically necessary.

“Medicare’s hospice benefit is designed to serve a vulnerable population of terminal, cancer-stricken patients. Providers who doctor notes and submit false claims not only take advantage of our tax dollars but also the already weakened cancer sufferers. In each of the cases mentioned earlier, individuals employed by the defendants came forward and reported fraud putting an end to the wrongful schemes,” said Theresa Vitello.

Individuals with evidence of hospice fraud can contact the qui tam attorneys at LPK for a free and confidential consultation via a 24/7 hotline at 212-605-6200 or toll free at 1.888.FRAUD.USA (1.888.372.8387), or by submitting an email inquiry at the firm's website.

*justice.gov/usao/flm/press/2013/july/20130722_HPH.html
**justice.gov/opa/pr/2013/March/13-civ-326.html
***justice.gov/opa/pr/2013/May/13-civ-500.html

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