In one of the most flagrant cases of hospice fraud ever uncovered, Andre Kirkland was sentenced in U.S. District Court in Oxford, Mississippi earlier this month.  Kirkland owned and operated Revelation Hospice in Clarksdale, Mississippi and enrolled patients in hospice care with complete disregard for hospice eligibility or patient care.  For example, Kirkland, who enrolled patients himself and supervised all Revelation nursing staff, enrolled a 29 year old pregnant female who was not terminally ill and not in any way hospice eligible.  In fact, she remains in good health today, years after Kirkland enrolled her in hospice care.

This patient was not an anomaly in Kirkland’s fraud, a medical review of a sample of 30 Medicare patients enrolled at Revelation revealed that 100% of those patients were not hospice eligible.  Further, Revelation had a live discharge rate of 93.3%, meaning over 93% of patients were discharged form Revelation while still living.  The national average live discharge rate at the time was 18.2%.

Kirkland’s fraud did not just rob government health care programs and the taxpayers but also put patients in significant danger.  According to patient interviews, Kirkland deceived patients about the true nature of hospice and the care they were signing up to receive.  As part of this deception, many patients unknowingly signed Do Not Resuscitate forms along with undated hospice revocation forms.  Kirkland would later use the revocation forms to discharge patients from hospice, without the patient’s knowledge, to shirk actually providing care if patients needed it.

“Hospice fraud has reached epidemic proportions in Northern Mississippi,” said Derrick L. Jackson, Special Agent in Charge at the U.S. Department of Health and Human Services, Office of Inspector General. “Patients are being falsely diagnosed as terminally ill in order to line the pockets of hospice owners who are treating Medicare like their own personal ATM.”

Kirkland pled guilty to conspiracy to commit healthcare fraud on May 4, 2016 and on September 1, 2016 he was sentenced to 48 months in home confinement and ordered to pay nearly $5.5 million in restitution.

The case was a criminal case, investigated by the United States Department of Health and Human Services Office of the Inspector General, the Medicaid Fraud Control Unit of the Mississippi Attorney General’s Office, and the Federal Bureau of Investigation. However, under the qui tam provisions of the False Claims Act, whistleblowers with information about similar fraud against the government may bring a civil case on behalf of the United States. If successful, the government can recover three times the amount the defendants fraudulently billed the government.  The whistleblower, who originally filed the case, is entitled to 15-30% of the government’s recovery as well as their attorney’s fees.