Results

Results: 37
Case Type
Type of Entity
Hospice, Individual
Court or Location
Texas - Southern District
Allegations
A hospice company, a home health company, and their owners agreed to pay more than $1.8 million to settle allegations that they provided payments to physicians under medical directorship agreements in exchange for the referral of patients, in addition to providing gifts and selling interests in one of the companies to several physicians.
Case Type
Civil
Type of Entity
Hospice
Court or Location
New York - Eastern District
Allegations
A hospice provider agreed to pay more than $4.8 million to settle allegations that it billed Medicare and Medicaid for services at heightened levels of care when the patients receiving the services did not qualify for those levels.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Florida - Middle District
Allegations
A hospice provider agreed to pay $3.2 million to settle allegations that it submitted claims to Medicare for patients who were not terminally ill and submitted claims to Medicare, Medicaid, and TRICARE for inpatient hospice care when such a level of care was unnecessary.
Case Type
Civil
Type of Entity
Hospice, Individual
Court or Location
Georgia - Northern District
Allegations
A hospice provider and two of its senior executives agreed to pay $1.75 million to settle claims that it submitted claims for hospice benefits for patients who were not terminally ill. The company also submitted claims for services provided by a physician who was not actually a provider at the hospice, but instead was paid to be a "back up" medical director.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Alabama - Northern District
Allegations
A hospice provider agreed to pay $1 million to settle allegations that it submitted claims to Medicare for patients who were not terminally ill and thus, not eligible for the Medicare hospice benefit.
Case Type
Type of Entity
Hospice, Laboratory & Diagnostic
Court or Location
Virginia - Eastern District
Allegations
A hospice provider agreed to pay $3.1 million to resolve allegations that it billed Medicare for hospice services provided to patients who did not meet hospice eligibility guidelines.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Pennsylvania - Eastern District
Allegations
A hospice provider agreed to pay almost $6 million to settle allegations that it submitted Medicare claims for hospice care that was not medically necessary or for which required documentation was lacking.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Tennessee - Eastern District
Allegations
A hospice provider agreed to pay $8.5 million to settle allegations that it submitted Medicare claims for patients who were not terminally ill.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Florida - Southern District
Allegations
Hospice service providers agreed to pay $2.5 million to settle allegations that they submitted Medicare claims for patients who were not eligible for the services.
Case Type
Civil
Type of Entity
Hospice
Court or Location
New York - Southern District, New York - State
Allegations
A long-term care provider agreed to pay $10.3 million to resolve state and federal FCA allegations. It is alleged Centerlight submitted fraudulent requests to New York’s Medicaid program for monthly premiums and failed to repay Medicaid for falsely-obtained payments. New York’s Medicaid program will receive $6.36 million in restitution and penalties from the total settlement payment.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Pennsylvania - Western District
Allegations
A hospice company and its CEO agreed to pay $1.24 million to resolve allegations the company fraudulently billed Medicare and Medicaid for hospice services for patients who were ineligible for hospice because they did not have a life expectancy prognosis of six months or less.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Florida - Middle District
Allegations
A hospice company agreed to pay more than $5 million to settle allegations that it submitted claims to Medicare for hospice services that were not supported with adequate documentation, resulting in reimbursements being received for hospice care for longer terms than appropriate.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Missouri - Western District
Allegations
A hospice services provider agreed to pay $75 million to resolve allegations that it submitted claims to Medicare for hospice services provided to patients who were not eligible for hospice services and provided employees with bonuses based on the number of patients receiving hospice services, regardless of patient eligibility. The settlement also covers claims that the company submitted claims for services provided at the highest rate when the services required were at lower rates.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Pennsylvania - Eastern District
Allegations
The owners of a now-defunct hospice facility agreed to turn over $8 million in assets to resolve FCA allegations that through their business, they billed Medicare for services supposedly provided to patients who were not eligible for hospice services.
Case Type
Civil
Type of Entity
Hospice
Court or Location
New Jersey - District
Allegations
A for-profit hospice provider agreed to pay $2 million to resolve FCA allegations that it admitted patients who did not qualify for hospice care and provided unneeded services to them on the basis of a medically unjustified diagnosis of “debility.”
Case Type
Civil
Type of Entity
Hospice
Court or Location
Georgia - Northern District
Allegations
A hospice group agreed to pay $2.4 million to resolve FCA allegations that it paid a medical director for referrals and also entered into sham contracts with associate medical directors in exchange for referrals. The company then submitted claims to Medicare and Medicaid for services provided to the referred patients.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Texas - Northern District
Allegations
Several hospice companies agreed to pay $12.21 million to resolve FCA allegations that they submitted claims to Medicare and Texas Medicaid that were rendered false as a result of the payment of kickbacks by the hospices, their owners and employees, and others.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Michigan - Eastern District
Allegations
A hospice provider and related entities agreed to pay $200,000 to resolve FCA allegations that it contributed more than $15,000 to a cancer charity established by a physician, in exchange for the referral 23 patients for hospice care, in violation of the Anti-Kickback Statute.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Colorado - District
Allegations
A hospice provider agreed to pay $18 million to resolve FCA allegations that it claimed Medicare reimbursement for hospice care for patients who were not eligible for such care because they were not terminally ill and because their medical records did not support that they were terminally ill. The government alleged that the provider's business practices were designed to maximize the number of patients for whom it could bill Medicare without regard to whether the patients were eligible for and needed hospice.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Puerto Rico - District
Allegations
A hospice service provider agreed to pay $2.5 million to resolve FCA allegations stemming from a government investigation which purportedly uncovered approximately $1.5 million in questionable billings submitted to Medicare Part A. As part of the settlement, the company agreed to enter into a five-year CIA with HHS-OIG.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Iowa - Northern District
Allegations
A hospice provider agreed to pay $1.08 million to resolve FCA allegations that it improperly billed for hospice services because, during some or all of the period that certain patients were receiving hospice care, the patients did not have a medical prognosis of six months or less if their illnesses ran their normal course.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Florida - Middle District
Allegations
A hospice provider agreed to pay $3.02 million to resolve FCA allegations that it billed Medicare and Medicaid for medically unnecessary hospice care for at least 52 patients who had lengths of stay greater than 1,000 days. The government asserted that the documentation for these patients failed to support the length of hospice services, failed to document basic patient characteristics and included unsigned records or records signed with inconsistent practitioner information. Certain patients were allegedly admitted to the hospice because their spouse was in hospice care; other patients purportedly were approved to take multiple, lengthy, out-of-state trips during a five-year period.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Arizona - District
Allegations
A hospice company and its founder and former president agreed to pay $2.2 million to resolve FCA allegations that it billed Medicare for hospice services for patients that were ineligible to receive such services. As part of the settlement, the company agreed to enter into a five-year CIA with HHS-OIG, and its owner agreed to a five-year exclusion from federal healthcare programs.
Case Type
Civil
Type of Entity
Home Health, Hospice
Court or Location
Georgia - Northern District
Allegations
A hospice provider and its affiliates agreed to pay $3 million to resolve FCA allegations that they billed Medicare for hospice patients who were not terminally ill. The government asserted that its business practices contributed to its submission of false claims, including failing to properly train staff and medical directors on the hospice eligibility criteria, establishing aggressive targets to recruit and enroll patients, and failing to adequately oversee the hospice.
Case Type
Civil
Type of Entity
Home Health, Hospice
Court or Location
Mississippi - Southern District
Allegations
A group of thirteen hospice entities and its majority owner and manager agreed to pay more than $5.86 million to resolve FCA allegations that they submitted false claims for delivery of continuous home care hospice services to patients when there was no crisis. According to the government, the hospice was identified as an outlier in billing for these services, the rate for which is the highest daily rate a hospice can bill Medicare. As part of the settlement, the organization agreed to enter into a five-year CIA with HHS-OIG.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Florida - Northern District
Allegations
A hospice provider agreed to pay more than $10.1 million to resolve FCA allegations that it overbilled for hospice services by billing for general inpatient care when medical records supported only the necessity of routine care.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Missouri - Western District
Allegations
A hospice company and several related entities agreed to pay $4 million to resolve FCA allegations they fraudulently certified patients as hospice-eligible even though the patients did not have a terminal prognosis of six months or less. As part of the settlement, each of the entities agreed to enter into a five-year CIA with HHS-OIG.
Case Type
Civil
Type of Entity
Hospice
Court or Location
New York - Southern District
Allegations
Two related hospice providers agreed to pay $4.9 million to the United States and $1.6 million to New York to resolve FCA allegations that they sought payment from Medicare and Medicaid for hospice nursing services that were not delivered according to several regulatory guidelines governing the provision of reimbursable hospice services. Specifically, a provider failed to treat patients according to an individualized plan of care, meet the needs of certain patients, make nursing services available 24/7 as required and maintain adequate clinical records, while the other entity failed to provide sufficient oversight through its compliance audits. As part of the settlement, they agreed to enter into five-year CIAs with HHS-OIG.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Georgia - Southern District
Allegations
A hospice provider and an affiliate agreed to pay $581,504 to settle FCA allegations that they billed Medicare for hospice services for patients who were ineligible for hospice care under Medicare regulations.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Alabama - Northern District
Allegations
A hospice provider agreed to pay $3.9 million to resolve FCA allegations that it billed federal and state healthcare programs for hospice services provided to patients who were not terminally ill under Medicare and Medicaid regulations. This settlement was announced in March 2014.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Florida - Middle District
Allegations
A hospice provider agreed to pay $3 million to resolve FCA allegations that it billed Medicare for patients that were not terminally ill as a result of instructing its staff to admit patients without regard to their Medicare eligibility, falsifying medical records for ineligible patients, employing field nurses without hospice training, delaying discharge for patients when they become ineligible for the Medicare hospice benefit, and implementing procedures to limit physicians’ roles in examining whether a patient is terminally ill. As part of the agreement, the organization entered into a five-year CIA with HHS-OIG.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Florida - Middle District
Allegations
A hospice provider agreed to pay $1 million to resolve FCA allegations that it submitted claims to Medicare for ineligible hospice services provided to patients who did not need end-of-life care or for whom the hospice billed at a higher reimbursement rate than it was entitled. The company also purportedly provided kickbacks through free services to skilled nursing facilities in exchange for patient referrals. As part of the agreement, the hospice entered into a five-year CIA with HHS-OIG.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Maryland - District
Allegations
Two hospice companies and their parent company agreed to pay $12 million to resolve FCA allegations that they submitted claims to Medicare for ineligible hospice services provided to patients who did not need end of life care or for whom the hospice billed at a higher reimbursement rate than it was entitled. As a part of the settlement, the parent organization entered into a CIA with HHS-OIG which provides for procedures and reviews to be put in place to avoid and promptly detect similar conduct.
Case Type
Civil
Type of Entity
Hospice, Individual
Court or Location
South Carolina - District
Allegations
A hospice company and its CEOand owner agreed to pay $1.3 million to settle FCA allegations that the company submitted bills to Medicare for medically unnecessary services because beneficiaries were ineligible for hospice care because they did not have a terminal prognosis of six months or less.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Georgia - Northern District
Allegations
A hospice provider agreed to pay $555,572 to settle FCA allegations that it submitted bills to the federal government for medically unnecessary services because patients did not qualify for the second highest level of hospice reimbursement – general inpatient care – because the patients did not meet the medical necessity requirement of a need for pain control or acute or chronic system management that could not be managed in another setting.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Kansas - District
Allegations
A hospice provider and its parent company agreed to pay $6.1 million to resolve FCA allegations that they billed federal programs for ineligible hospice services because patients did not have a medical prognosis of six months or less, and improper delays in discharges and misleading documentation resulting from employee payment based on patient census levels.
Case Type
Civil
Type of Entity
Hospice
Court or Location
Wisconsin - Eastern District
Allegations
A hospice provider agreed to pay $25 million to resolve allegations that it submitted false claims to federal programs for medically unnecessary continuous home care services billed at a higher rate than routine care services. As a result, the company entered into a CIA with HHS-OIG.