Published on:

Hospice & False Medicare Claims

Nursing home company misconduct takes various forms. Most notably,when corners are cut and employees act inappropriately then individual residents can be harmed. Nursing home neglect and abuse is an endemic problem that causes countless injuries and deaths each year.

But in recent years more and more attention has also been drawn to administration and business tactics used by companies that may violate the law. This form of misconduct often involves companies bilking the taxpayer via Medicare or Medicaid. A large portion of long-term care payments nationwide are ultimately drawn from these public programs. This means that everyone loses when long-term care companies violate rules in order to increase their billing unnecessarily. Many different state and federal rules are in place which dictate the parameters by which companies can bill these programs for provided services.

Misuse of Hospice Care
The problem flew under the radar for a significant period of time, but many advocates are now stepping forward and attempting to hold these large companies accountable for their actions.

One particular billing irregularity that caught the attention of officials involves abuse of hospice care. For example, late last year the U.S. Department of Justice announced a settlement with one hospice center following allegations that the company enrolled patients into hospice care who did not actually need those services.

According to the United States DOJ, the company in question agreed to pay $3 million in response to claims that it ran afoul of the False Claims Act and collected money from Medicare that it was not entitled to receive. Specifically, federal government officials argue that over a five year period the company leaders pushed staff members to admit all patients who were referred to their hospice program–without any regard for whether those patients actually qualified for the program per Medicare rules. Not only that, but officials claim that some staff members actually falsified medical records in an attempt to cover up their false enrollment. Officials also suggest that untrained nurses were employed, minimized the involvement of actual physicians, and kept patients enrolled even when not necessary.

Call for Whistleblowers
The U.S. DOJ notes that the allegations themselves were first brought to light when former employees of the alleged company came forward and explained what was going on. The settlement is therefore a reminder of the importance of current or former employees speaking out when they see wrongdoing. Under the False Claims Act, those who act as a whistleblower in these cases that result in a settlement or judgment to receive a portion of the money returned. This is built into the law specifically to act as a catalyst for those with knowledge to

If you have information about misconduct at a long-term care facility, from nursing homes and assisted living facility to hospice care center, please do not stay silent. Contact our nursing home attorneys today to share your story and see how we can help.

See Other Blog Posts:

Reminder: Keep an Eye Out for Elder Financial Exploitation

Five Tips for Detecting Elder Abuse or Neglect in Nursing Home Facilities