Florida Hospice Agrees to Pay $3 Million for Medicare Fraud Involving Patients That Were Not Terminally Ill
On Tuesday, November 5th, a Florida-based hospice agreed to pay $3 million to the federal government to resolve claims of Medicare fraud involving billings for patients that were not terminally ill.
Hospice of the Comforter Inc (HOTCI) agreed to pay $3 million to resolve all allegations that the company violated the False Claims Act by submitting false claims to the Medicare program for hospice services provided to patients who were not dying, and therefore not eligible for the Medicare hospice benefit, according to the Justice Department.
HOTCI is based in Altamonte Springs, FL, and serves Seminole, Osceola, and Orange counties in Florida.
“This settlement is a result of the Justice Department’s continuing efforts to prevent the abuse of the taxpayer-funded Medicare hospice program, which is intended to provide comfort and care to terminally ill persons during the last six months of their lives,” said Assistant Attorney General for the Civil Division Stuart F. Delery. “We will pursue those who seek to misuse this important benefit for their own enrichment.”
According to the federal government, between December 2005 and December 2010, the hospice company engaged in Medicare fraud, specifically through billings to the Medicare program for services to patients who were not terminally ill. The complaint against the company alleged that leaders directed employees to admit all referred patients, regardless of whether they were eligible for the Medicare hospice benefit. They also reportedly instructed staff to falsify records to make it appear as though patients were eligible when they were not, employed field nurses without hospice training, established procedures that would limit physicians’ roles in assessing patients’ terminal status, and delayed discharging patients when it became clear that they were not eligible for the hospice benefit.
“This settlement represents a fair and appropriate resolution of this troubling matter,” said Acting U.S. Attorney for the Middle District of Florida A. Lee Bentley III. “Hospice providers in our district should be on notice that our office will do what it takes to protect our citizens from this kind of misconduct.”
“Hospice care is a sacred trust from which no provider should fraudulently profit,” said Inspector General of the U.S. Department of Health and Human Services Daniel R. Levinson. “Claiming tax dollars for people who are not terminally ill ?? and therefore ineligible for hospice care ?? cannot be tolerated.”
HOTCI’s former Chief Executive Officer Robert Wilson agreed to a three-year, voluntary exclusion from federal health care programs, including Medicare and Medicaid. The facility itself agreed to enroll in a Corporate Integrity Agreement with the Inspector General for the Department of Health and Human Services in Florida that puts procedures and reviews in place to prevent further Medicare fraud.
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