{"id":361,"date":"2015-10-05T18:55:42","date_gmt":"2015-10-05T22:55:42","guid":{"rendered":"http:\/\/blogs.duanemorris.com\/healthlaw\/?p=361"},"modified":"2015-10-05T18:55:42","modified_gmt":"2015-10-05T22:55:42","slug":"recent-trends-in-fca-litigation-against-hospice-care-providers","status":"publish","type":"post","link":"https:\/\/blogs.duanemorris.com\/healthlaw\/2015\/10\/05\/recent-trends-in-fca-litigation-against-hospice-care-providers\/","title":{"rendered":"Recent Trends In FCA Litigation Against Hospice Care Providers"},"content":{"rendered":"

The Office of Inspector General identified <\/a>“reducing waste in . . .\u00a0hospice care” as one of the “top management challenges” for the 2015 fiscal year.\u00a0 \u00a0The federal government’s efforts to respond to that challenge\u00a0are\u00a0illustrated by\u00a0several\u00a0recent developments in False Claims Act (“FCA<\/em>“)\u00a0cases brought against hospice care providers.\u00a0 For example, the Robinson-Hill<\/em>, Betts<\/em>, and Gooch<\/em> cases discussed herein underscore the attention\u00a0given to hospice care providers and their alleged billing and personnel-related practices, and the high monetary settlements that can result from such attention.<\/p>\n

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Specifically, on October 2, 2015\u00a0a hospice provider\u00a0agreed\u00a0to a $16,000,000 settlement in exchange for the dismissal with prejudice of FCA, anti-kickback, and\u00a0other\u00a0related\u00a0claims.\u00a0\u00a0 Robinson-Hill et al. v. Nurses’ Registry and Home Health Corp<\/em>., Case No. 5:08-cv-00145 (E.D. Ky.)\u00a0\u00a0 As detailed in the settlement agreement, Robinson-Hill<\/em> arose out of allegations that the defendant violated the FCA by, among other things: (i) upcoding\u00a0the severity of patients’ medical conditions; (ii) providing medically unnecessary therapy services; (iii) recertifying patients for services for which those patients were no longer eligible; and (iv) backdating or falsifying patient records.\u00a0 (Case No. 5:08-cv-00145, Dkt. 310-1.)<\/p>\n

On October 1, 2015,\u00a0a collection of hospice care providers resolved an FCA case by way of a $3,000,000 settlement.\u00a0 U.S. ex rel. Betts et al., v. Texas Home Health of America LP et al<\/em>., Case No. 1:12-cv-00412 (N.D. Ga.)\u00a0\u00a0 As reported by the Department of Justice<\/a>, “[t]he government alleged that [the defendant] submitted or caused the submission of false claims for hospice care for patients who [the defendant] knew were not terminally ill.”\u00a0\u00a0The government also alleged that the defendant: (i)\u00a0“fail[ed] to properly train its staff and medical directors on the hospice eligibility criteria”; (ii)\u00a0“set[] aggressive targets to recruit and enroll patients”; and (iii) “fail[ed] to properly oversee the Atlanta hospice.”<\/p>\n

Finally, on September 24, 2015,\u00a0an individual associated with a hospice care provider was sued in Mississippi federal court for alleged FCA violations.\u00a0 U.S. v. Gooch<\/em>, Case No. 4:15-cv-140\u00a0(N.D. Miss.).\u00a0\u00a0 According to the complaint, the defendant was employed as a homemaker\/aide for Angelic Hospice and Palliative Care Services and in that role allegedly\u00a0conspired to submit false claims to Medicare for payments for hospice care that was either (i) not rendered or (ii) medically unnecessary.\u00a0 The defendant also allegedly received certain payments in exchange for her role in the submission of the false claims at issue.<\/p>\n

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The Office of Inspector General identified “reducing waste in . . .\u00a0hospice care” as one of the “top management challenges” for the 2015 fiscal year.\u00a0 \u00a0The federal government’s efforts to respond to that challenge\u00a0are\u00a0illustrated by\u00a0several\u00a0recent developments in False Claims Act (“FCA“)\u00a0cases brought against hospice care providers.\u00a0 For example, the Robinson-Hill, Betts, and Gooch cases discussed … <\/p>\n

Continue reading “Recent Trends In FCA Litigation Against Hospice Care Providers”<\/span><\/a><\/p>\n","protected":false},"author":158,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,413],"tags":[41,440,405,50,228,393,9,10,641],"ppma_author":[917],"class_list":["post-361","post","type-post","status-publish","format-standard","hentry","category-health-law","category-healthcare-litigation-2","tag-anti-kickback","tag-elinor-h-murarova","tag-false-claims-act","tag-healthcare","tag-healthcare-litigation","tag-hospice","tag-medicaid","tag-medicare","tag-settlement"],"authors":[{"term_id":917,"user_id":158,"is_guest":0,"slug":"ehart","display_name":"Elinor H. Murarova","avatar_url":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-content\/uploads\/sites\/8\/2015\/01\/hartelinor-125x150.jpg","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/posts\/361","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/users\/158"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/comments?post=361"}],"version-history":[{"count":0,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/posts\/361\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/media?parent=361"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/categories?post=361"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/tags?post=361"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/blogs.duanemorris.com\/healthlaw\/wp-json\/wp\/v2\/ppma_author?post=361"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}