Home Health & Hospice Week

Haven Hospice, the hospice provider that recently announced the closing of affiliate VNA and Hospice of the Florida Keys, has agreed to pay $5.1 million to resolve allegations that Haven billed Medicare for medically unnecessary and undocumented hospice services.

Since June 2011, Gainesville, Florida-based Haven treated at least 63 patients with lengths of stay exceeding three years, the Department of Justice said in a release issued right before Christmas. The DOJ listed the hospice provider's flaws: "Haven's diagnoses were not adequately supported, or were supported only with inconsistent practitioner information. Many patients failed to demonstrate objective indications of decline throughout their time in the company's care, despite some being in hospice for nearly six years. Some patients had their hospice diagnoses changed after several years when they did not show decline under their original 'terminal' diagnosis."

The agreement settles a whistleblower lawsuit filed by former Haven employee Dr. John Simons, who will receive about $900,000 of the settlement, according to the DOJ.

"Unfortunately, some healthcare providers seek to defraud Medicare by billing for unnecessary hospice services," said Acting U.S. Attorney W. Stephen Muldrow in the release. "This settlement should serve as notice to others who consider similar practices that we will vigorously pursue them."

Haven Hospice President Gayle Mattson said the hospice agreed to the settlement "without any admission of liability in order to avoid delay and the expense of litigation," adding that hospice care is a "complex and constantly changing industry" where it is common to have differing interpretations of regulations, reports The Florida Times-Union newspaper in Jacksonville.