Home Health & Hospice Week

Alleged high pressure on employees to recruit and retain patients ineligible for the Medi-care hospice benefit has resulted in at least two whistleblower lawsuits in which the government has partially intervened.

The suits charge that management at Ever-care Hospice and Palliative Care, now known as Optum Palliative and Hospice Care, “pressured employees and physicians to admit and retain patients who were not terminally ill and challenged or disregarded physicians’ decisions that patients should be discharged,” according to a Department of Justice release. The practices resulted in Eden Prairie, Minn.-based Evercare “knowingly submitting false claims for hospice benefits for patients who did not have a life expectancy of six months or less,” the qui tam relators claim.

One of the whistleblower suits names Ever-care’s parent companies, including UnitedHealth Group, the DOJ notes.

“The decision to provide hospice services should be prompted by a patient’s terminally ill medical condition and desire for palliative care, not a hospice provider’s desire to boost its profits,” HHS Office of Inspector General Special Agent in Charge Gerald Roy says in the release.