Home Health & Hospice Week

Though 2024 is looking like it’s going to be a banner year for Medicare enforcement, the 2023 statistics show last year was one for the ages, according to the Department of Justice.

For the fiscal year 2024, which ended on Sept. 30, 2023, False Claims Act settlements surpassed $2.68 billion, according to a DOJ release on Feb. 22. In addition, “the government and whistleblowers were party to 543 settlements and judgments, the highest number of settlements and judgments in a single year,” DOJ crows.

Healthcare-related fraud accounted for more than $1.8 billion of that staggering amount and 348 of the qui tam cases, according to DOJ statistics. Find the DOJ release on the 2023 FCA numbers at www.justice.gov/opa/pr/false-claims-act-settlements-and-judgments-exceed-268-billion-fiscal-year-2023.

The latest case: In California, a physician could face up to 10 years in prison for fraudulently certifying that Medicare patients needed hospice services when they didn’t. Between October 2014 and March 2016, Dr. John Thropay worked with a number of hospices in and around Van Nuys, including Blue Sky Hospice Inc. During his tenure, he “fraudulently certified Medicare patients of Blue Sky as having terminal illnesses that the patients did not have so that Blue Sky Hospice could bill Medicare for hospice services,” DOJ notes in a release.

Thropay, who fraudulently billed Medicare for the hospice services at upward of $2.8 million, was convicted by a jury and is scheduled to be sentenced on May 28. He’s facing up to 10 years.