February 20, 2015

DOJ Catch of the Week — Compassionate Care Hospice

By the C|C Whistleblower Lawyer Team

This week’s Department of Justice “catch of the week” goes to Compassionate Care Hospice Group and Compassionate Care Hospice of New York. On Wednesday, the hospice services provider agreed to pay more than $6.5 million to settle charges it violated the federal and New York False Claims Acts by submitting claims to Medicare and Medicaid for hospice nursing services not actually or adequately provided. Under the settlement, CCH will pay the US roughly $5 million for defrauding Medicare and New York State roughly $1.7 million for defrauding Medicaid. See DOJ Press Release and NYAG press release.

As part of the settlement, CCH New York accepted responsibility for failing, at its Bronx location, to treat patients according to an individualized plan of care, failing to meet the needs of certain patients, failing to make nursing services available 24 hours a day and seven days a week as required, and failing to maintain adequate clinical records. And CCH Group accepted responsibility for failing to provide sufficient oversight of CCH New York through its compliance audits. Specifically, the government alleged nurses employed by CCH-New York routinely missed their required visits and then, at the direction of management in the Bronx office and with the knowledge of CCH Group, falsified nursing notes in patients’ files to make it appear as though the visits had been performed. CCH, nonetheless, billed Medicare and Medicaid for services not actually performed or not performed in compliance with the applicable regulations, and received millions of dollars as a result of the fraudulent claims.

In announcing the settlement, Manhattan U.S. Attorney Preet Bharara said: “In addition to protecting public monies, this settlement agreement protects patients who require hospice care, by holding Compassionate Care Hospice accountable for providing inadequate services and sending a message to all similarly situated providers.” New York Attorney General Eric Schneiderman echoed these strong words, cautioning “those who defraud Medicaid are looting from taxpayers and depriving vulnerable New Yorkers of important medical care, and my office will hold them accountable.” The allegations first arose in a whistleblower lawsuit filed under the qui tam provisions of the New York and federal False Claims Acts by a former employee of CCH’s Bronx location.

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