Home Health & Hospice Week

Are recent subpoenas a sign of an industry crackdown?

The booming hospice sector is seeing more fraud and abuse troubles.

The HHS Office of Inspector General has subpoenaed hundreds of patient records from hospice chain VITAS Healthcare Corp. The probe relates to "VITAS' alleged failure to appropriately bill Medicare and Medicaid for hospice services," VITAS parent Chemed Corp. says in a release.

The OIG selected 80 patient records from VITAS' three largest programs and another 80 records from various VITAS locations, the company explains.

Cincinnati-based Chemed Corp. bought Miami-based VITAS for $410 million in February of last year (see Eli's HCW, Vol. XIII, No. 1).

The OIG probe of VITAS comes not too long after a U.S. Department of Justice investigation of another hospice giant - for-profit, publicly traded Odyssey HealthCare Inc.(see Eli's HCW, Vol. XIII, No. 38).

The DOJ's False Claims Act investigation focuses on patient admissions, retention and billing, Odyssey has said. The company also faces numerous shareholder lawsuits that were sparked by its exceeding the Medicare per-patient hospice cap.

Observers suspect the hospice sector's high-profile expansion and profitability have given rise to the feds' fraud and abuse concerns. And that concern may trickle down to smaller hospice providers soon.

ORT All Over Again?

VITAS says the types of records requested are similar to those investigated under the Operation Restore Trust probe in the late 1990s. Under ORT, the OIG audited six VITAS programs and more than 1,000 records, but took no adverse actions against the company."

Two of the three programs specifically identified in the current OIG investigation are included in the six programs previously investigated by the OIG," VITAS notes in the release.

"VITAS is fully cooperating with the OIG in this investigation," Chemed CEO Kevin McNamara says. "We believe VITAS has developed systems and procedures that meet or exceed those necessary to support Medicare and Medicaid billings."