Under the Medicare Hospice Benefit, patients who have been diagnosed with six months or less to live may receive government-funded palliative care. Qualifying patients who elect the Medicare Hospice Benefit must agree to forego curative care. The most common type of Medicare Hospice Fraud involves marketing hospice services to non-terminal patients and admitting and re-certifying them for payment under the Medicare Hospice Benefit. Such fraud is particularly disturbing, because it not only defrauds taxpayers and skims the already overextended healthcare budget but more importantly it coerces non-terminal patients to forego vital curative treatment. In addition to the fraudulent admission and re-certification of non-terminal hospice patients, Frohsin & Barger has identified and uncovered several other types of Medicare Hospice Fraud including:
- Fraudulently coercing patients to “voluntarily discharge” before expensive hospital visits in order to shift such expensive costs away from the hospice company;
- Fraudulently back-dating admission and discharge elections;
- Providing less services than required by the patient care plan;
- Paying kickbacks in the form of in-kind services to nursing homes and other facilities;
- Fraudulently manipulating the Medicare Cap by a variety of schemes.
On January 15, 2009, Frohsin & Barger announced the country’s largest civil settlement involving allegations of Medicare Hospice Fraud and the largest whistleblower settlement in Alabama history, recovering $24.7 million of taxpayer funds through cooperation with the Department of Justice, the United States Attorney for the Northern District of Alabama, and the Department of Health and Human Services. The whistleblowers who reported the fraud received an award of almost $5 million.