Hospice fraud has taken a hairpin turn into the hard-to-prosecute, harming honest hospice care providers, the government and whistleblowers alike.
In our evolved and humane culture, it’s only right that our elderly and terminal patients have a pleasant, government-supported place to spend their final days. Yet in the wake of the Affordable Care Act, it seems many hospice care centers have chosen to capitalize on the unprecedented potential of Medicare payments by filing claims that result in hospice fraud.
Among the companies under the microscope recently are Palliative Services of the Treasure Coast and Horizons Hospice. Both of them paid millions of dollars in fines for false Medicare claims, explains Home Health Care News. Given this, the U.S. Department of Health & Human Services Office of Inspector General is now cracking down on hospice centers. They are more determined than ever to ensure government money gets spent wisely.
Yet the case is not that simple.
A Troubled Trial from the Start
The trial against AseraCare is a perfect illustration of how difficult it may prove to come to a decision over hospice care fraud. Among her various decisions over a several-year period, Judge Karon Owen Bowdre did anything but clarify or streamline the case. Her actions over that time include:
- Splitting the case into two separate trials to address a) the fraud allegations and b) to treat the rest of the claims against AseraCare
- Assertions she did not provide adequate instructions upfront, leading to the judge overturning the jury’s finding that AseraCare submitted 104 of its 121 claims falsely
- Tossing out the case entirely, stating that with the vast disagreement over whether or not a patient is terminally ill, it’s impossible to prove the falsity
Today, the decision rests with the 11th Circuit Court of Appeals, but the timeline is hazy at best, nonexistent at worse.
The result, to say the least, is massive confusion across the industry. Honest providers feel targeted and insecure. They are uncertain how to “ensure” their patients will really live six months or less. On the other hand, dishonest providers are happy to jump at the chance this troubling case provides. Whistleblowers, lastly, feel understandably helpless.
Confusion Persists, but Injustice Doesn’t Have To
Despite the recent claims that prosecuting hospice fraud grows ever more impossible, that’s not the case. Are you are a whistleblower concerned about injustice and misuse of government money? There is a place for you in the courtroom.
Come see us at Bothwell Law Group, where we dedicate all our energy to representing qui tam whistleblowers. A successful claim can mean rewards for you and support of the U.S. government, so don’t wait. Call us at 770.643.1606 today.