Archive

Sixteen charged in $60M Medicare hospice fraud scheme

By the C|C Whistleblower Lawyer Team The Department of Justice announced yesterday that a grand jury returned an indictment charging 16 Texas individuals with participating in a scheme to commit healthcare fraud, billing Medicare and Medicaid over $60 million for fraudulent hospice services, of which the government actually paid over $35 million. Defendants allegedly improperly placed patients in hospice and...

DOJ Catch of the Week -- Evercare

This week's Department of Justice "Catch of the Week" goes to Evercare Hospice and Palliative Care.  On Wednesday, the Minnesota-based provider of hospice care agreed to pay $18 million to resolve charges it violated the False Claims Act by claiming Medicare reimbursement for hospice care for patients not eligible for such care because they were not terminally ill.  The government trumpeted the settlement as...

In Their Own Words — Jackson

-- “Hospice care is only medically appropriate – and reimbursed by Medicare – for terminally ill patients who are in the last months of their lives.  We will continue to vigorously investigate health care companies that put their own profits above their duty to give appropriate medical care to their patients and bill Medicare only for legitimate health care services.”  

Special Agent in Charge Derrick L....

DOJ Catch of the Week -- Alive Hospice

By the C|C Whistleblower Lawyer Team This week's Department of Justice "Catch of the Week" goes to Tennessee-based non-profit hospice care provider Alive Hospice, Inc. Yesterday, the DOJ announced the company paid roughly $1.5 million to reimburse the government for alleged violations of the False Claims Act through overbilling of Medicare and TennCare for hospice services. See DOJ Press Release.   The...

The AseraCare Trial Gears Up and Creates Ripples for Larger Hospice Industry

By Mary Inman and Ari Yampolsky The issue teed up in the Government's trial against AseraCare cuts to the core of Medicare’s hospice benefit.  A Medicare beneficiary is eligible for hospice care only if two doctors certify that she is “terminally ill.”  This means that her illness will lead to her death within six months, if the illness runs its normal course.  Because Medicare beneficiaries who choose...

As AseraCare Trial Begins, Judge Narrows What Government Can Present to the Jury

by Mary Inman and Ari Yampolsky Yesterday's AseraCare trial began like all others with the empaneling and swearing in of the jury.  However, unlike juries in other False Claims Act trials, this jury will only be provided with a narrow slice of the evidence.  Judge Bowdre has divided the trial into phases and, in an unusual move, has severely restricted what the Phase One jury will consider. Although there are...

DOJ Enforcement Spotlight -- Cancer Doctor Farid Fata

By the C|C Whistleblower Lawyer Team Last Friday, the Department of Justice secured a 45-year prison sentence against the now infamous Detroit-area doctor, Farid Fata.  He was also ordered to forfeit $17.6 million of illegal reimbursements he obtained from Medicare and private insurance companies.  This stems from his guilty plea in September 2014 to violating the False Claims Act with a health care fraud scheme...

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...