Arizona Hospice Will Pay $12 Million to Settle Claims It Treated Ineligible Medicare Patients

An Arizona hospice company will pay $12 million to settle charges that it bilked Medicare by inflating bills and admitting patients who weren’t ready for end-of-life care.

The U.S. Department of Justice reached the agreement with Hospice of Arizona L.C. The hospice was originally sued, along with two related companies, by whistleblower Ellen Momeyer, a former hospice employee; she will get $1.8 million for her role in the case.

Momeyer sued under the qui tam provision of the False Claims Act (FCA), which allows private parties to sue on behalf of the United States for fraudulent use of government funds, and to share in any recovery.  The government may intervene in the lawsuit, but has no obligation.

In this case, the Justice Department said, Hospice of Arizona spent eight years pushing its staff to find lucrative Medicare patients – then overbilled the government and kept patients at the hospice even when they didn’t need such services.

Medicare pays for hospice care, but only for terminally ill patients who expect to live six months or less. Hospices don’t try to cure illnesses; they treat symptoms such as pain and try to minimize patients’ suffering during their last months of life.

The Obama administration continues to wield the FCA as a weapon against Medicare and Medicaid fraud; since 2009 it has recovered more than $10 billion in similar FCA cases.

The Employment Law Group® law firm’s whistleblower attorneys have helped many clients file suit against employers that fraudulently bill the U.S. government, and have established favorable precedents under the retaliation provision of the False Claims Act.

Tagged: False Claims Act (FCA), Fraud Types, Medicare Fraud, Whistleblower Laws (Federal)