Home Health and Hospice
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In Their Own Words — Jackson
Posted 10/5/15
-- “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
Posted 09/11/15
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...
August 24, 2015
The New York Attorney General announced a $6 million dollar settlement with Empire State Home Care Services, Inc. (Empire), a home care agency operating out of Brooklyn, NY. The settlement resolves claims that Empire improperly reported its home health aide hours as well as administrative and general expenses on cost reports filed between 2002 and 2005. These cost reports were used to set the reimbursement rates that Empire received from the state for the years 2004 through 2007 and resulted in over $3 million in reimbursements to which Empire was not entitled. NYAugust 9, 2015
Constantine Cannon partner Mary Inman was quoted in the AL.com article, Whistleblower trial: Did AseraCare hospice bill Medicare for patients who weren't about to die? Click here to read the article.The AseraCare Trial Gears Up and Creates Ripples for Larger Hospice Industry
Posted 08/6/15
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
Posted 08/5/15
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...
July 29, 2015
New York Attorney General Eric T. Schneiderman announced the sentencing of the executive director of a company for stealing funds from the Nursing Home Transition and Diversion program, a Medicaid-funded program that provides senior citizens and those suffering from physical disabilities an alternative to institutional living through the use of Medicaid funds for renovations to the homes of the elderly and disabled (wheelchair ramps, grab bars, etc.). Defendant plead guilty to grand larceny, based on the submission of bids and cost reports, which falsely stated the actual costs of the projects, significantly inflating the actual costs or including services which were never provided. NYDOJ Enforcement Spotlight -- Cancer Doctor Farid Fata
Posted 07/14/15
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...