Medicare funds spent on hospice care has spiked aggressively in the last decade, reaching a staggering $15.1 billion per year in 2012. As it turns out, some of this increased spending was due to fraud committed by hospices to render unnecessary services, and then bill Medicare for them.
Under Medicare regulations, hospices are only paid for the admission and care of beneficiaries who are terminally ill, which is defined to mean having a life expectancy of six months or fewer. However, hospices have been taking advantage of Medicare by admitting patients who are in good health, and then re-admitting them after they inevitably survive for more than six months. What is supposed to be a one-time palliative expense balloons into repeated payments, costing Medicare and taxpayers untold sums of wasted spending. Furthermore, in many cases the hospice patients actually receive inadequate care. Instead of upholding their duty to care for some of the most vulnerable Americans, these offending hospices are merely exploiting the elderly for their own financial gain.
To combat this widespread abuse, the federal government has become more aggressive in pursuing claims of hospice fraud. In 2017 alone, the government has already settled for hundreds of millions of dollars in hospice fraud litigation brought forth by whistle-blowers. Some of the bigger fish netted include Chemed, which will pay $75 million, and Genesis Healthcare, which will pay $53.6 million. These cases were only settled because of the efforts of the hospice employees who were willing to come forward as whistle-blowers.
Hospice workers who notice that their employers are intentionally, or even recklessly, admitting patients with longer than six months life expectancy can save Medicare millions of dollars by contacting a qualified qui tam attorney. In addition, to incentive transparency, the government may award up to 30 percent of the penalties it collects to these hospice whistle-blowers, but the complaint must be filed through a hospice fraud attorney. That is to commence a proper Qui Tam and to protect you along the way, the law mandates you have a whistleblower lawyer.