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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsHospice providers fined $75 Million for falsely billing Medicare
Glad to read that Vitas has been fined. They provided Hospice care for my father - not a memory I want to revive.
...Chemed Corporation and various wholly-owned subsidiaries, including Vitas Hospice Services LLC and Vitas Healthcare Corporation, have agreed to pay $75 million to resolve a government lawsuit alleging that defendants violated the False Claims Act (FCA) by submitting false claims for hospice services to Medicare. Chemed, which is based in Cincinnati, Ohio, acquired Vitas in 2004. Vitas is the largest for-profit hospice chain in the United States.
"Today's resolution represents the largest amount ever recovered under the False Claims Act from a provider of hospice services, said Acting Assistant Attorney General Chad A. Readler of the Justice Departments Civil Division. Medicares 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.
The settlement resolves allegations that between 2002 and 2013 Vitas knowingly submitted or caused to be submitted false claims to Medicare for services to hospice patients who were not terminally ill. Medicares hospice benefit is available for patients who elect palliative treatment (medical care focused on the patients relief from pain and stress) for a terminal illness and have a life expectancy of six months or less if their disease runs its normal course. Patients who elect the hospice benefit forgo the right to curative care (medical care focused on treating the patients illness). The governments complaint alleged that Vitas billed for patients who were not terminally ill and thus did not qualify for the hospice benefit. The government alleged that the defendants rewarded employees with bonuses for the number of patients receiving hospice services, without regard to whether they were actually terminally ill and whether they would have benefited from continuing curative care.
The settlement also resolves allegations that between 2002 and 2013, Vitas knowingly submitted or caused to be submitted false claims to Medicare for continuous home care services that were not necessary, not actually provided, or not performed in accordance with Medicare requirements. Under the Medicare hospice benefit, providers may be reimbursed for four different levels of care, including continuous home care services. Continuous home care services are only for patients who are experiencing acute medical symptoms causing a brief period of crisis. The reimbursement rate for continuous home care services is the highest daily rate that Medicare pays, and hospices are paid hundreds of dollars more on a daily basis for each patient they certify as having received continuous home care services rather than routine hospice services. According to the complaint, the defendants set goals for the number of continuous home care days billed to Medicare and used aggressive marketing tactics and pressured staff to increase the volume of continuous home care claims, without regard to whether the patients actually required this level of crisis care....
"Today's resolution represents the largest amount ever recovered under the False Claims Act from a provider of hospice services, said Acting Assistant Attorney General Chad A. Readler of the Justice Departments Civil Division. Medicares 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.
The settlement resolves allegations that between 2002 and 2013 Vitas knowingly submitted or caused to be submitted false claims to Medicare for services to hospice patients who were not terminally ill. Medicares hospice benefit is available for patients who elect palliative treatment (medical care focused on the patients relief from pain and stress) for a terminal illness and have a life expectancy of six months or less if their disease runs its normal course. Patients who elect the hospice benefit forgo the right to curative care (medical care focused on treating the patients illness). The governments complaint alleged that Vitas billed for patients who were not terminally ill and thus did not qualify for the hospice benefit. The government alleged that the defendants rewarded employees with bonuses for the number of patients receiving hospice services, without regard to whether they were actually terminally ill and whether they would have benefited from continuing curative care.
The settlement also resolves allegations that between 2002 and 2013, Vitas knowingly submitted or caused to be submitted false claims to Medicare for continuous home care services that were not necessary, not actually provided, or not performed in accordance with Medicare requirements. Under the Medicare hospice benefit, providers may be reimbursed for four different levels of care, including continuous home care services. Continuous home care services are only for patients who are experiencing acute medical symptoms causing a brief period of crisis. The reimbursement rate for continuous home care services is the highest daily rate that Medicare pays, and hospices are paid hundreds of dollars more on a daily basis for each patient they certify as having received continuous home care services rather than routine hospice services. According to the complaint, the defendants set goals for the number of continuous home care days billed to Medicare and used aggressive marketing tactics and pressured staff to increase the volume of continuous home care claims, without regard to whether the patients actually required this level of crisis care....
https://www.justice.gov/opa/pr/chemed-corp-and-vitas-hospice-services-agree-pay-75-million-resolve-false-claims-act
http://www.wallerlaw.com/News-Events/Bulletins/103038/An-In-Depth-Look-at-the-Fraud-Charges-Against-Vitas-Hospice-Services?utm_source=Mondaq&utm_medium=syndication&utm_campaign=View-Original
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Hospice providers fined $75 Million for falsely billing Medicare (Original Post)
mia
Oct 2017
OP
The pukes will solve it by passing a law that you can't sue them for malpractice or any other reason
FreeStateDemocrat
Oct 2017
#6
niyad
(113,332 posts)1. utterly despicable
onethatcares
(16,170 posts)2. notice the amount of the fine.
and then notice the amount bilked isn't listed.
Those bad guys, I bet they even kept their homes, cars, childrens private school, vacation days and maybe even got a bonus for stringing the fraud out so long.
Good thing they didn't get caught with 4 grams of non legal week. They'd be facing some real time.
niyad
(113,332 posts)3. you might want to read this as well:
mia
(8,361 posts)4. Thanks for this information
I had no idea that Hospice can mean "No Care".
niyad
(113,332 posts)5. and bilking medicaid for that "no care"
FreeStateDemocrat
(2,654 posts)6. The pukes will solve it by passing a law that you can't sue them for malpractice or any other reason