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Table of Contents

$18M Medicare Scam Lands Geisinger Community Health Services in Hot Water

HARRISBURG, PA — Geisinger Community Health Services (GCHS) has been caught red-handed in a massive Medicare scam, agreeing to pay $18,513,621.05 to resolve allegations of civil liability for submitting claims to Medicare for hospice and home health services that violated Medicare rules and regulations.

According to a shocking report, between January 2012 and December 2017, GCHS submitted claims to Medicare for hospice and home health services that violated Medicare rules and regulations regarding physician certifications of terminal illness, patient elections of hospice care, and physician face-to-face encounters with home health patients. The scheme was uncovered after GCHS voluntarily disclosed the violations.

Geisinger Community Health Services’ $18 million payment is a stark reminder of the importance of following Medicare rules and regulations, said Acting U.S. Attorney Brandler. ‘Healthcare fraud remains a focus of the government and the Affirmative Civil Enforcement Unit of the United States Attorney’s Office,’ he added.

Healthcare providers like GCHS must be held accountable for their actions, and this settlement sends a clear message that Medicare scams will not be tolerated. The fact that GCHS voluntarily disclosed the issues and worked to address the problems that led to these violations is commendable.

The case was handled by the HHS, Office of Counsel to the Inspector General (OCIG), the Justice’s Commercial Litigation Branch, Fraud Section, and AUSA Tamara Haken of the Affirmative Civil Enforcement Unit of the U.S. Attorney’s Office for the Middle District of Pennsylvania.

GCHS’s actions have set a precedent for other healthcare providers to follow, emphasizing the importance of transparency and accountability in the healthcare industry.

As the government continues to crack down on Medicare scams, it is essential for healthcare providers to prioritize compliance and avoid costly mistakes like GCHS.