Hospice Care of Kansas LLC and its parent company, Ft. Worth, Texas-based Voyager
HospiceCare Inc., have agreed to pay $6.1 million to resolve allegations that
they violated the False Claims Act by submitting claims to the Medicare program
for ineligible hospice services, the Justice Department announced today. Hospice
Care of Kansas currently provides hospice services throughout the state of
Kansas. Hospice Care of Kansas, which is based in Wichita, Kansas, was purchased
by Voyager in 2004.
The Medicare hospice benefit is available for patients who elect palliative
treatment (medical care focused on providing patients with relief from the
symptoms, pain, and stress of a serious illness) for a terminal illness and who
have a life expectancy of six months or less if the disease runs its normal
course. Today’s settlement resolves allegations that Hospice Care of Kansas and
Voyager submitted or caused the submission of false Medicare claims between
January 2004 and December 2008 for beneficiaries that did not have a terminal
prognosis of six months or less.
The government alleged that Hospice Care of Kansas and Voyager engaged in
certain practices that resulted in the submission of false claims, including the
provision of compensation to clinical
employees based on patient census and admissions, delaying discharges of
patients determined not to have a six month or less prognosis, instructions to
staff to document patient conditions in a misleading manner, and implementation
of an inadequate compliance
program.
“The Medicare hospice benefit is intended to provide comfort and care to terminally ill persons in
the final stages of their disease,” said Stuart F. Delery, Acting Assistant
Attorney General for the Department of Justice’s Civil Division. “This
settlement shows that the Department of Justice will not tolerate hospice
providers that attempt to maximize their profits at the expense of their legal
and ethical obligations to the Medicare program, taxpayers, and
beneficiaries.”
“Our goals are to protect taxpayer dollars, ensure the viability of
government health care programs, and strengthen our national health care
system,” said Barry Grissom, U.S. Attorney for the District of Kansas. “This
case is a step in that direction.”
“We expect providers of Medicare services to operate with the utmost
integrity and with the best interests of our beneficiaries in mind. Working with
our partners at the Department of Justice, we will hold those accountable who do
not operate in this manner,” said Gerald Roy, Special Agent in Charge, U.S.
Department of Health and Human Services, Office of Inspector General.
The allegations that are the subject of today’s settlement were originally
raised in a lawsuit filed by a former Hospice Care of Kansas nurse, Beverly
Landis, under the qui tam, or whistleblower, provisions of the False Claims Act.
The act allows private citizens with knowledge of fraud to bring an action on
behalf of the United States and share in any recovery. As a part of today’s
resolution, Ms. Landis will receive payments totaling $1.342 million.
This resolution is part of the government’s emphasis on combating health care fraud and another step
for the Health Care Fraud Prevention and Enforcement Action Team (HEAT)
initiative, which was announced by Attorney General Eric Holder and Kathleen
Sebelius, Secretary of the Department of Health and Human Services, in May 2009.
The partnership between the two departments has focused efforts to reduce and
prevent Medicare and Medicaid financial fraud through enhanced cooperation. One
of the most powerful tools in that effort is the False Claims Act, which the
Justice Department has used to recover more than $7.7 billion since January 2009
in cases involving fraud against federal health care programs. The Justice
Department’s total recoveries in False Claims Act cases since January 2009 are
over $11.3 billion.
The investigation was jointly handled by the Justice Department’s Civil
Division, the FBI, the Office of the
Inspector General of the Department of Health and Human Services, and the U.S.
Attorney’s Office for the District of Kansas. The claims settled by this
agreement are allegations only, and there has been no determination of
liability.
No comments:
Post a Comment