Home Health & Hospice Week

Whistleblowers will receive half a million.

If you expect your employees to keep your operational details in-house, think again.

Two former employees of Guardian Hospice of Georgia filed a whistleblower lawsuit in

January 2012 and the government intervened in the case, notes the whistleblower firm representing the staff, The Bothwell Law Group, in a release.

“Guardian’s business practices contributed to its submission of claims for patients who did not have a terminal prognosis of six months or less,” alleges the Department of Justice in a release. Those practices included “failing to properly train its staff and medical directors on the hospice eligibility criteria, setting aggressive targets to recruit and enroll patients, and failing to properly oversee the Atlanta hospice,” according to the DOJ. Justice also pointed out that Guardian is for-profit in the release.

Whistleblowers Rose Betts and JenniferWilliams “routinely witness[ed] non-terminal patients

being treated,” according to Bothwell. The qui tam relators “were told that it was necessary to keep the hospice’s ‘census’ up, no matter what it took to keep Medicare/Medicaid paying for their care, including fabricating diagnoses and falsifying supporting documentation,” they alleged in their suit. Guardian, Guardian Home Care Holdings Inc., and AccentCare Inc. agreed to pay $3 million

to resolve allegations that from 2009 to 2012, Guardian knowingly submitted false claims to the Medicare program for hospice patients who were not terminally ill, the DOJ says. Dallas-based AccentCare acquired Guardian in 2011 (see Eli’s HCW, Vol. XX, No. 6).

Targets: “We will continue to aggressively pursue companies that abuse the Medicare hospice benefit to improperly inflate their profits,” says Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the DOJ’s Civil Division, in the release. ?

Note: See the amended complaint at www.whistleblowerlaw.com/wp-content/uploads/2015/10/First-Amended-Complaint-090415.pdf.