According to DoJ, Diakon Lutheran Social Ministries d/b/a Diakon Hospice Saint John “has agreed to resolve its liability for violations of the False Claims Act (FCA) by paying the United States $10.56 million.” Diakon –one of the oldest hospices in Pennsylvania (serving Hazelton, Allentown, and Wyomissing) — stood up and did the right thing: it voluntarily disclosed improper billing practices and repaid the money it falsely billed Medicare. In doing so, it avoided paying the treble damages and civil penalties authorized under the federal False Claims Act, which can run as much as $11,000 per false claim.
“Health care providers that make billing compliance, self- policing, and self reporting a priority foster trust in the health care industry” said Nick DiGiulio, Special Agent in Charge for the United States Department of Health and Human Services’ Office of Inspector General. “These actions demonstrate that Diakon Hospice Saint John cares about returning money, incorrectly attained, to our federal health payment programs.”
Unfortunately, very few companies act so responsibly once they discover false claims to Medicare. As Bloomberg News and others have recently reported, false claims to Medicare by profit-driven hospices are a widespread practice according to former employees and executives. Others should follow the lead of Diakon and report their false claims and seek reform through implementing rigorous corporate compliance programs. If they fail to do so, the False Claims Act encourages individuals who have knowledge of such false claims to come forward and share as much as 25% or more of the recovery.