DOJ’s Largest Recovery from Hospice Provider for Medicare Fraud

The Department of Justice recently announced the resolution of a false claims act case against two hospice service providers for $75 million. The case arose out of three separate whistleblower actions and represents the largest recovery from a provider of hospice services.  The awards to the whistleblowers have not yet been determined.  Under the False Claims Act, the award for bringing a claim on behalf of the government ranges between 15 and 30 percent of the amount recovered.

The claims were filed against Chemed Corp. and Vitas Hospice Services – the largest for-profit hospice chain in the United States. The allegations involve the submission of false claims to Medicare between 2002 and 2013 for services to hospice patients who were not terminally ill and for continuous home care services that were not necessary, not actually provided, or not performed in accordance with Medicare requirements.

That the fraud was in connection with hospice care was not lost on the DOJ.  As Acting Assistant Attorney General Chad A. Readler explained: “Medicare’s hospice benefit provides critical services to some of the most vulnerable Medicare patients, and the Department will continue to ensure that this valuable benefit is used to assist those who need it, and not as an opportunity to line the pockets of those who seek to abuse it.”

There is no question that Medicare and Medicaid fraud costs taxpayers billions of dollars and represents a major concern for the DOJ.  According to Steve Hanson, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of Inspector General, Kansas City Region: “Healthcare providers who knowingly overbill our programs simply to increase their profits need to be put on notice that such conduct will not be tolerated, and we will pursue any and all remedies at our disposal to protect the tax payer and the Medicare and Medicaid programs.”

The full text of the DOJ announcement can be found here.