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Criminal Medicare Hospice Fraud

May 12, 2009

Six people have been indicted for criminal Hospice fraud in California for allegedly paying healthy seniors to be admitted to a hospice for the terminally ill and then billing state and federal health care programs for “phantom procedures” never performed, according to a press release by California Attorney General Edmund G. Brown, Jr. Additionally, the indictment alleges that the patients were fraudulently admitted into the Medicare Hospice Benefit, because they were not dying. In order to qualify for the Medicare Hospice Benefit, patients must have a diagnosis from their treating physician that they have less than six months to live. Fraudulent Hospice admissions is a growing concern for the DoJ.

In January of 2009, Frohsin & Barger negotiated the largest Medicare Hospice settlement in the country resolvolving allegations that SouthernCare Hospice submitted false claims to Medicare through a pattern and practice of fraudulently certifying and re-certifying patients who were not terminal and who did not qualify for the Medicare Hospice Benefit. The near $25 Million settlement resolved a whistleblower Complaint by a former nurse who worked for SouthernCare. For more on the SouthernCare settlement read Frohsin & Barger’s Press Release and the United States Attorney for the Northern District of Alabama’s Press Release.

To report Medicare Hospice fraud, contact Frohsin & Barger.

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