Atlanta Hospice Care Fraud Attorney
Hospice care helps families facing an end-of-life situation provide for the medical and psychological health of a family member. When an illness is incurable, hospice care can kick in, helping our loved ones face death with dignity.
However hospice care can be rife with fraud. Someone on Medicare or Medicaid typically can receive hospice care when a doctor certifies they have less than six months to live. Government programs like Medicare and Medicaid are often targets of fraud.
Stacey Evans Law is prepared to help anyone willing to blow the whistle on fraud in the hospice industry. It is illegal to submit fraudulent billings to Medicare or Medicaid. Kickbacks are also illegal. Contact us today to learn more.
Examples of Hospice Care Fraud
Each year, roughly 1.6 million people receive hospice care, and the U.S. government spends tens of millions of dollars on hospice annually. With so much money being paid out, scammers often hope that their schemes will avoid detection. And often they are right.
Some common fraudulent schemes include:
- Offering kickbacks to nursing homes or hospitals to refer patients for hospice services.
- Admitting patients to hospice who are ineligible and billing for their services.
- Keeping patients in hospice even though the patient’s health improves.
- Inappropriate billing for unnecessary hospice services.
- Insufficient patient evaluation to determine whether a patient needs hospice services.
To perpetuate schemes, many hospice providers keep inadequate records or outright falsify records to keep the scheme going and make fraud harder to detect. Several individuals and business entities can be in on the fraud, including hospital or nursing home administrators, hospice providers, and doctors—all of whom may get a cut of the illegal profits generated by the scheme.
Hospice Fraud & Nursing Homes
Many fraudulent schemes involve hospice providers and nursing homes. The reality is that many elderly enter nursing homes without any chance of getting well, so hospice eventually is needed for many residents. However, some hospice providers and nursing homes enter into illegal agreements which include kickbacks.
It is illegal to offer any type of payment or gift in exchange for medical referrals payable by a government program such as Medicare or Medicaid. Nevertheless, some hospice providers and nursing homes have created complicated arrangements.
For example, a hospice provider might agree to provide dramatically discounted services to obtain referrals from a nursing home. These discounted services are a type of kickback. In return, a nursing home funnels patients to the hospice provider even though the patient does not need hospice services.
In other schemes, the hospice program will refer patients to the nursing home on an exclusive basis. The nursing home profits, usually by billing for nursing home services the patient did not need.
Blow the Whistle on Fraud in the Hospice Industry
If you have knowledge of hospice fraud, you might bring a claim under the False Claims Act. This federal law allows citizens to sue on the federal government’s behalf to recoup money paid out for false claims. A whistleblower can then keep a percentage of the amount recovered as incentive for stepping forward.
It pays to blow the whistle on fraud. Contact Stacey Evans Law to speak with an Atlanta hospice care fraud attorney today.
