Home Health & Hospice Week

Billing Medicare for ineligible hospice patients has led to a $3.1 million penalty for one of the nation’s largest home care and hospice providers.

Kindred Healthcare Inc. has paid the penalty for not complying with the Corporate Integrity Agreement that its 2014 acquisition, Gentiva, received when it negotiated a $25 million settlement for improper hospice billing (see Eli’s HCW, Vol. XXI, No. 8). Gentiva, in turn, had inherited the billing problems causing the settlement from its $1 billion acquisition of hospice chain Odyssey in 2010. (The billing improprieties at issue occurred from 2006 to 2009.)

The HHS Office of Inspector General fined Kindred when a series of site visits uncovered noncompliance with the CIA’s terms in the fourth year of the five-year agreement, the OIG says in a release. It’s the largest fine for a CIA violation to date, the OIG says.

“Kindred was billing Medicare for hospice care for patients who were ineligible for hospice services or who were not eligible for the highest level and most highly paid category of service,” according to the OIG. Kindred closed 18 “underperforming” hospice locations after its CIA-required audits revealed the billing problems.

However, “in 2016 the company took significant corrective actions, including upgrading internal audits and investigations and tracking resolutions of identified issues,” the OIG adds in the release.