Former Employees Allege Hospice Submitted False Claims to Medicare for Palliative and Continuous Home Care Services
The United States government has decided to join a lawsuit started by whistleblowers against Home Care Hospice, Inc., a provider of hospice services, and the company’s owners.
The lawsuit was started by two former employees who allege that the hospice company submitted false claims to Medicare for palliative and crisis care services. Under the qui tam or whistleblower provisions of the False Claims Act, individual citizens may start a lawsuit on behalf of the government and share in any recovery.
The qui tam or whistleblower lawsuit was initially filed “under seal” (in secret). After conducting an investigation, the government decided to join the lawsuit. If the government recovers money from the defendants as a result of the lawsuit, the whistleblowers will be entitled to a reward of between 15% and 25% of the amount recovered.
The former employees allege that the hospice company and its owners submitted false claims to Medicare for palliative care to patients who did not qualify. They also allege that the defendants submitted false claims for continuous home care services that were not medically necessary or not actually provided.
The Medicare hospice benefit pays for palliative care for patients who have a life expectancy of six months or less. Palliative care is focused on providing the patient with relief from the pain and stress of terminal illnesses. A patient who chooses palliative care no longer receives medical services intended to cure the terminal illness.
The whistleblowers allege that the hospice company and its owners created false medical records and submitted false claims to Medicare for patients who were not terminally ill.
The whistleblowers also allege that the defendants created false medical records and submitted false claims to Medicare for continuous home care services that were not medically necessary or not actually provided.
Continuous home care services, also known as crisis care, are provided to terminally ill patients who experience acute medical symptoms on a temporary basis. The crisis care services usually include skilled-nursing services for a short period to allow the patient to remain at home. Medicare reimburses continuous home care at a much higher rate than the usual palliative care services provided by hospices.
If you have evidence that a hospice is submitting false claims to Medicare, then you should consult with an experienced Medicare fraud whistleblower lawyer immediately. You may be entitled to a significant reward and legal protections as a whistleblower.