Home Health & Hospice Week

Whistleblowers may be able to place a target on your agency for a False Claims Act investigation, but apparently they don’t hold much sway over settlement details with the government.

Hospice of the Comforter Inc. in the Or-lando, Fla., area has agreed to pay $3 million to re-solve allegations it billed for hospice services provided to patients who were not eligible for the Medicare hospice benefit, the Justice Department says in a release. Former Hospice of the Comforter VP of finance Douglas Stone filed a whistleblower suit against the hospice in 2011, claiming execs kept ineligible patients on service for long periods of time for financial gain (see Eli’s HCW, Vol. XXI, No. 31). Then he filed a legal brief in court to oppose the $3 million settlement amount between the hospice and the government, calling it a "travesty" (see Eli’s HCW, Vol. XXII, No. 37).

However, the DOJ stuck with the $3 million amount, according to the release. The hospice "allegedly directed its staff to admit all referred patients without regard to whether they were eligible for the Medicare hospice benefit, falsified medical records to make it appear that certain patients were eligible for the benefit when they were not, employed field nurses without hospice training, established procedures to limit physicians’ roles in assessing patients’ terminal status and delayed discharging patients when they became ineligible for the benefit," the DOJ says.

Plus: The hospice will enter into a corporate integrity agreement with the HHS Office of Inspector General, which is standard. And former CEO Robert Wilson has agreed to a three-year, voluntary exclusion from Medicare, Medicaid and other federal health care programs.

"This settlement represents a fair and appropriate resolution of this troubling matter," Acting U.S. Attorney for the Middle District of Florida A. Lee Bentley III says in the release. However, "Stone’s share of the recovery has not been determined," the DOJ notes.