Evercare Hospice and Palliative Care has agreed to pay $18 million to settle a False Claims Act suit alleging that the company enrolled patients in hospice care that were not terminally ill. When patients enroll in hospice care, they forgo treatment for their medical conditions and instead receive care designed to make them comfortable in their last days. According to the government, Evercare enrolled patients whose medical records showed that they were not, in fact, terminally ill, and therefore should not have been in hospice care. According to the DOJ press release, the government alleged that:
Evercare knowingly submitted or caused to be submitted false claims to Medicare for hospice care from Jan. 1, 2007, through Dec. 31, 2013, for Medicare patients who were not eligible for the Medicare hospice benefit because Evercare’s medical records did not support that they were terminally ill. The government’s complaint alleged that Evercare’s business practices were designed to maximize the number of patients for whom it could bill Medicare without regard to whether the patients were eligible for and needed hospice. These business practices allegedly included discouraging doctors from recommending that ineligible patients be discharged from hospice and failing to ensure that nurses accurately and completely documented patients’ conditions in the medical records.
The allegations were brought to light by former employees. Under the False Claims Act, the employees will receive a portion of the money recovered by the government as a reward for blowing the whistle.
Read the DOJ press release