Crossroads Hospice, which operates facilities in Ohio and Tennessee, has recently agreed to pay $5.5 million to resolve allegations that it violated the False Claims Act by submitting claims to Medicare for patients who were not terminally ill.
The case alleged that Crossroads Hospice, from Jan. 1, 2012, to Dec. 31, 2014, knowingly submitted false claims for patients diagnosed with dementia or alzheimer’s disease, a U.S. Department of Justice (DOJ) press release said.
“Medicare’s hospice benefit provides critical end-of-life services that focus on palliative rather than curative care,” Acting Assistant Attorney General Brian M. Boynton of the Justice Department’s Civil Division said in the release. “This settlement demonstrates our continuing commitment to ensure that hospice services are provided to patients who truly need this care and that patients who are not terminally ill receive appropriate curative care.”
Patients in hospice receive medical care focused on providing relief from symptoms in the final stages of life. It generally starts when life expectancy is six months or less, the release said. Hospice patients typically do not receive medical care to remedy their condition.
“The decision to provide hospice services should be prompted by a patient’s terminally ill medical diagnosis and desire for palliative care, not a hospice provider’s desire to boost its profits,” said Special Agent in Charge Lamont Pugh III of U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “Our agency is dedicated to safeguarding both the Medicare program and Medicare patients. This settlement reaffirms HHS-OIG’s commitment to holding accountable providers who knowingly submit false claims to Medicare.”
The public can report potential fraud, waste, abuse and mismanagement to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).
