Home Health & Hospice Week
Hospice Execs Sentenced In Fraud Cases
Benchmark: National live discharge rate is 18%.
Hospices with sky-high live discharge rates drive their law-abiding counterparts crazy and slap the industry with a bad name, but at least authorities are taking some action on the issue.
After pleading guilty to Medicare fraud in May, the owner/Director of Nursing for Revelation Hospice in Clarksdale, Miss., has received a 48-month home confinement sentence and must repay $5.4 million, the Department of Justice says in a release. The judge allowed home confinement for Andre Kirkland instead of prison because he has metastatic cancer, the DOJ says.
Kirkland and Revelation were knowingly enrolling ineligible Medicaid and Medicare recipients, according to the DOJ. “A medical review of a 30-patient Medicare patient sample revealed that 100 percent of those patients were not eligible. Revelation had a live discharge rate of 93.3 percent,” the release notes. In contrast, the national live discharge rate is 18.2 percent, according to the DOJ.
“Hospice fraud has reached epidemic proportions in Northern Mississippi,” Derrick L. Jackson, HHS Office of Inspector General Special Agent in Charge, says in the release. “Patients are being falsely diagnosed as terminally ill in order to line the pockets of hospice owners who are treating Medicare like their own personal ATM.”
In another case: The former COO of Horizons Hospice in Pittsburgh has received a 15-month prison sentence following her guilty plea in June to Medicare fraud (see Eli’s HCW, Vol. XXV, No. 22).
Mary Ann Stewart had asked for home confinement and sobbed to the judge that she was not a bad person, reports the Pittsburgh Post-Gazette.
Prosecutors noted that despite earning more than $300,000 a year in salary, Stewart took Medicare and Medicaid proceeds and used it for herself for restaurant meals, gift cards, and party buses. The judge handed down the prison sentence, noting that Stewart had lied to a grand jury in the course of the investigation, says the Post-Gazette. Stewart will also have to pay $175,000 in restitution.
Home Health & Hospice Week
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Hospice Execs Sentenced In Fraud Cases
Benchmark: National live discharge rate is 18%. Hospices with sky-high live discharge rates drive their [...] - Fraud & Abuse:
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