Hospice Medicare Fraud Whistleblowers are needed to step forward and blow the whistle on large hospice care providers that are falsely certifying patients that do not qualify for hospice care. If you are aware of a large hospice care provider or other health care company that is defrauding Medicare through hospice fraud or other types of health care fraud, please feel free to contact Texas Hospice Fraud Whistleblower Lawyer, Jason S. Coomer, via e-mail or via our online submission form for a free review of a potential Hospice Fraud Whistleblower Lawsuit.
Hospice Medicare Fraud Can Occur When A Hospice Care Provider Falsely Certifies or Recertifies Patients That Are Not Eligible For Hospice Benefits
Hospice Care Providers that practice a pattern of enrolling and recertifying non-terminal patients and billing for continuous care that isn't necessary or reasonable can be committing Hospice Medicare Fraud. Other Hospice Care Providers that fraudulently maximize the use of Medicare’s hospice benefit by pressuring its employees to enroll people into hospice who aren’t dying and resist discharging them despite evidence they weren’t deteriorating can also be committing Hospice Medicare Fraud that can be the also be the basis of a Hospice Federal False Claims Act Whistleblower Reward Lawsuit. These Hospice Medicare Fraud Schemes typically have a large health care and hospice provider recruite patients eligible for skilled nursing care for 20 days, for which Medicare pays the entire bill. After the 20 days, when Medicare requires patients pick up a part of the tab, the health care and hospice provider will send the patients to hospice to collect a flat payment from Medicare for each day they are enrolled. In these fraudulent arrangements a patient will typically be referred and re-referred until that patient has received—and Medicare has been billed for—the maximum number of days of skilled nursing care, including rehabilitative therapy, home health care, and hospice care.
By being the first to expose a hospice Medicare fraud scheme, a hospice Medicare fraud whistleblower can receive a substantial reward for properly blowing the whistle on fraudulent hospice care providers.
Hospice Medicare Fraud Is A Growing Problem and Cost
Law enforcement authorities estimate that health-care fraud costs taxpayers between $60 billion and $100 billion each year. Through Health Care and Hospice Qui Tam claims and Health Care & Hospice Fraud Lawsuits billions of dollars have been recovered from individuals and organizations that have committed health care fraud on the United States Government and State Governments.
Over the 29 years that Medicare has reimbursed providers for hospice services, it has been praised for giving critical medical and emotional support to dying patients and their families. The Medicare hospice benefit is intended to provide compassionate end of life care to terminally ill patients and not to line the pockets of large hospice providers that are attempting to maximize profits at the expense of taxpayers. More specifically, Medicare provides a benefit meant to cover hospice care for the terminally ill. It covers 24-hour in-home nursing service only during limited crisis periods. When properly used at the very end of a person's life, hospice care can also save the government money by reducing medical treatments and keeping the person comfortable. Hospice patients agree to forgo treatments aimed at prolonging their lives, but can receive pain-relieving medication to ease the symptoms of a terminal illness, as well as attention from nurses, social workers and others.
However, as for profit hospice providers are seeking to maximize their profits, we are seeing more and more use of the hospice Medicare benefit. It is now being used by over a million Medicare patients a year and the numbers are expected to continue to increase. It is estimated that 40% of Medicare beneficiaries now use the hospice benefit before they die. Medicare's bill for hospice care rose to more than $12 billion in 2009 from $2.9 billion in 2000. These numbers are expected to grow as more and more hospice providers seek to maximize their profits.
Although the benefit is intended for patients who have no more than six months to live, 19 percent now receive hospice services for longer, according to the Medicare Payment Advisory Commission, or MedPAC, an independent congressional oversight panel. In 2009, 10 percent of patients remained in hospice beyond seven months. Medicare pays a flat fee ranging from $147 to $856 a day, depending on the level of care, whether a hospice actually provides services or not.
Hospice Fraud Whistleblower Lawsuits Are On The Rise
Health care fraud costs United States Tax Payers large amounts of money through Medicare, Medicaid, and other government health care programs. A critical aspect of the Health Care Fraud problem is that Medicare, the health program for the elderly and the disabled, automatically pays the vast majority of the bills it receives from companies that possess federally issued supplier numbers. Computer and audit systems now in place to detect problems generally focus on over billing and unorthodox medical treatment rather than fraud.
There have been several large health care providers that have been made to pay large multimillion dollar fines for hospice fraud lawsuits. These lawsuits include cases against Odyssey Healthcare Inc. and SouthernCare.
HOSPICE FRAUD NETS MULTIMILLION DOLLAR RECOVERY
"SouthernCare Inc. and its shareholders have agreed to pay the United States a total of $24.7 million to settle allegations that the Birmingham, Ala.-based company submitted false claims to the government for patients treated at its hospice facilities, the Justice Department announced today. SouthernCare operates approximately 99 locations that provide hospice services in 15 states."
“The Medicare hospice benefit is intended to provide compassionate end of life care to terminally ill patients,” said Gregory G. Katsas, Assistant Attorney General of the Civil Division. “This settlement sends a clear message that the Department of Justice will not allow health care providers to take advantage of beneficiaries in their attempts to game the reimbursement system.”
This settlement results from two qui tam suits filed by two former SouthernCare employees on behalf of the United States. The False Claims Act authorizes private parties to file suit against those who defraud the United States and to receive a share of any recovery. The United States will pay $4.9 million to the individuals who filed the actions against SouthernCare.
“Our investigation showed a pattern and practice to falsely admit patients to hospice care who did not qualify and to bill Medicare for that care. This resulted in taxpayers bearing inappropriate costs. This settlement evidences the Department of Justice’s efforts to both protect the public monies and safeguard Medicare beneficiaries,” said Alice H. Martin, U.S. Attorney for the Northern District of Alabama.
Texas Hospice Medicare Fraud Lawyer and Hospice Fraud Whistleblower Lawyer Jason S. Coomer Commonly Works with Hospice Fraud Lawyers, Hospice Fraud Qui Tam Lawyers, and Health Care Fraud Whistleblowers Lawyers Throughout Texas and the United States
As a Texas Hospice Medicare Fraud Whistleblower Lawyer, he works with other powerful qui tam lawyers that handle large governmental fraud cases. He works with San Antonio Hospice Fraud Qui Tam Lawyers, Dallas Hospice Fraud Lawyers, Houston Hospice Health Care Fraud Lawyers, and other Texas Hospice Fraud Qui Tam Lawyers as well as with Hospice Qui Tam Lawyers throughout the nation to blow the whistle on fraud that hurts the United States.
If you are aware of a Health Care Provider, Hospice Provider, Defense Contractor, highway contractor, large health care company, or other large contractor or subcontractor that is defrauding the United States Government out of millions or billions of dollars, contact Texas Hospice Health Care Fraud Qui Tam Lawyer Jason Coomer.