Hospice Pays $3 Million in Fraud Claims Settlement
In a recent fraud claims settlement, which highlights the firm’s extensive track record in healthcare fraud litigation, Georgia area hospice center Guardian Hospice has reached a $3 million settlement. Together with their affiliated organizations, Guardian Home Care Holdings and AccentCare, Guardian Hospice was accused by relators (whistleblowers) of submitting false claims to Medicare and Medicaid.
The false claims submitted were for hospice patients in their care who were not terminally ill, thereby improperly capturing government funds by providing this false information. The legal team used the settling of this lawsuit to pursue justice for two former Guardian employees whose sealed case was filed in 2012. Although Guardian did not admit to being liable for the fraud, they still agreed to a $3 million settlement.
What can we learn from this fraud claims settlement?
Since the whistleblowers in this case filed their claim under the False Claims Act, the relators were successfully awarded a $510,000 reward for their actions, representing a standard statutory share of the government’s recovery. In addition to this, two of the whistleblowers believed Guardian wrongfully terminated them. As a result, our legal framework allows whistleblowers to seek damages for employment retaliation, which resulted in an additional $50,000 for Rose Betts and $40,000 for Jennifer Williams to resolve the retaliation they claimed to have faced at the hands of their former employers.
In a statement to the media at the time of the settlement, it was shared that the clients had grown accustomed to watching their employer offer hospice care to non-terminal patients. In order to receive reimbursement for their care, the hospice center submitted false claims to Medicare and Medicaid, communicating that these patients were in the last six months of their lives.
In a statement concerning the case, Derrick Jackson, special agent who was placed in charge of the U.S. Department of Health and Human Services Office of the Inspector General, explained why this is such a gross misuse of funds.
“Hospice care is only medically appropriate—and reimbursed by Medicare—for terminally ill patients who are in the last months of their lives,” Jackson stated.
The McCabe Law Firm emphasizes that throughout these types of healthcare cases, it is very clear the U.S. government is not the only victim of the fraudulent actions.
Patients who do not meet criteria for hospice care, but are admitted anyway, miss out on the treatment a traditional hospital would provide, potentially missing a chance for their illness to be cured. Without the actions of the whistleblowers, who were wise when they selected a law firm that was experienced in whistleblower law and fraud claims settlement, this fraud might have continued to be committed in the future.
If you have reason to believe your employer may be committing Medicare or Medicaid fraud, contact The McCabe Law Firm to learn more about filing a qui tam lawsuit and protecting your rights with our experienced legal team.
