Home Health & Hospice Week
Qui Tam Suit Costs Hospice $2.5 Million
A whistleblower lawsuit filed by hospice physicians has cost one nonprofit Florida hospice $2.5 million - and it could have been much worse. Health and Palliative Services of the Treasure Coast Inc., The Hospice of Martin and St. Lucie Inc., and Hospice of the Treasure Coast Inc. have paid $2.5 million to settle the case, the Department of Justice says in a release. The hospice billed Medicare for ineligible patients, the DOJ says. Physicians John Simons and Lewis Cook received more than $476,000 from the announced recovery, according to the DOJ. In a statement furnished to local news outlet TCPalm.com, Treasure Coast said "the actual care that was provided to patients was never in question; this has been a dispute over documentation," the website reports. However, relator Cook told TCPalm.com that top executives ordered doctors to "find a way" to keep Medicare beneficiaries in hospice for as long as possible. The whistleblower complaint alleged employees were trained to falsify documentation to make stable but chronically ill patients appear terminally ill and to underestimate patients' life expectancies, the website reports. Also: The hospice's then-CEO allegedly told the doctors to "shut up" and "just sign the order" for inpatient admissions, among other shady practices, according to court records. The hospice's settlement amount was relatively low because a larger one would have put the provider out of business, the whistleblowers' attorney told TCPalm.com.
Home Health & Hospice Week
- Pre-Claim Review:
It's Baaaack — CMS Re-Proposes Home Health Pre-Claim Review
Know these 3 crucial differences between the old and new PCR program. Just when you [...] - Reimbursement:
Face-To-Face Problems Drive PCR Troubles
Postpayment review limits your documentation improvement options. Don't expect the changes in the Pre-Claim Review [...] - Targeted Probe & Educate:
Nearly 1/3 Of Claims Fail Palmetto TPE Review So Far
Plan of Care denials top Palmetto GBA's list. Another HHH MAC has released preliminary Targeted [...] - Compliance:
Use These 7 Tips To Protect Your Claims Against TPE Denials
Ignoring ADRs pretty much guarantees more review, expert warns. The consequences for not performing well [...] - Medical Review:
Revise Your Thinking On TPE Rounds
Round timing is provider-specific under new initiative. Getting a clear picture of the Targeted Probe [...] - Industry Note:
Damaging Hospice Prosecution Grabs Headlines Again
Hospice director of operations turns star witness. Mainstream news stories outlining Medicare hospice fraud and [...] - Industry Note:
MedPAC Lacks A Home Care Representative Yet Again
The newest crop of MedPAC commissioners is heavy on physicians and light - extremely - [...] - Industry Note:
Walk Through The TPE Basics With New Video
With the latest Targeted Probe & Educate review results not looking good (see story, p. [...] - Industry Note:
Tell Staff To Beware New Mileage Deduction Limitations
If you don't pay the full Internal Revenue Service mileage rate to your employees for [...] - Industry Note:
OIG Schools Providers On Integrity Agreements
Find out more about Corporate Integrity Agreements in a new less-than-three-minute video from the HHS [...] - Industry Note:
Home Care Fraud Trial Ends In Guilty Verdict For Doc
After a four-day trial, a federal jury has convicted Michigan physician Millicent Traylor on charges [...] - Industry Note:
Qui Tam Suit Costs Hospice $2.5 Million
A whistleblower lawsuit filed by hospice physicians has cost one nonprofit Florida hospice $2.5 million [...] - Make The Most Of Your Eli's Home Care Week Subscription
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