Hospice Giant SouthernCare Fines $24.7M for Fraudulent Claims

Health care giant SouthernCare Inc. is facing a staggering $24.7 million fine after federal prosecutors revealed the company’s fraudulent billing practices for hospice services.

The Birmingham, Ala.-based firm, which operates in 15 states, stands accused of submitting false claims to the government for patients who were not eligible for hospice care. The scam resulted in taxpayers footing an inappropriate bill for end-of-life services.

Federal prosecutors allege that SouthernCare admitted patients to hospice care without proper justification and billed Medicare for their treatments. Assistant Attorney General Gregory G. Katsas stressed, ‘This settlement makes it clear that the feds will not tolerate health care providers exploiting Medicare beneficiaries to enrich themselves.’

The investigation was a joint effort by federal prosecutors in Alabama and Georgia, along with the Justice Department’s Civil Division, HHS Inspector General, and the FBI. Two former employees, Tanya Rice and Nancy Romeo, filed the qui tam suits that led to the settlement.

Today’s fine is part of a broader effort to protect Medicare trust funds from fraud and abuse. U.S. Attorney David E. Nahmias emphasized, ‘Every provider must ensure proper billing practices, and falsely admitting patients to hospice care endangers both patients and the health care system.’

In addition to the monetary penalty, SouthernCare will enter a Corporate Integrity Agreement with the HHS Office of Inspector General to address future compliance with Medicare and Medicaid hospice eligibility requirements.