GRIMY TIMES EXCLUSIVE: In a shocking expose of Medicare abuse, the government has intervened in a whistleblower lawsuit against Hospice of the Comforter Inc. (HOTCI), alleging the Orlando-based hospice firm knowingly submitted false claims to Medicare for patients who were not terminally ill.
According to the lawsuit filed by HOTCI’s former vice-president of finance, Douglas Stone, the hospice firm’s CEO verbally instructed employees to admit Medicare recipients for hospice care even where there had not yet been a determination that they were eligible for the hospice benefit.
“The hospice benefit is intended only for people who qualify for and require such care,” said Stuart F. Delery, Acting Assistant Attorney General for the Civil Division. “We will continue to protect this important component of the Medicare program by ensuring that entities providing hospice care are only treating, and billing for, qualified patients.”
AUDIT REVEALS WIDESPREAD ABUSE: The lawsuit also alleges that HOTCI formed an internal committee to review the eligibility of its Medicare patients and discharged at least 150 patients in 2009-2010 as being ineligible for the Medicare hospice benefit.
“Some of the most vulnerable people in our district rely on hospice services,” said Robert O’Neill, U.S. Attorney for the Middle District of Florida. “It is critically important that Medicare remains solvent in order to provide hospice benefits, and that we confront those whose practices in this area put economic gain before patient care.”
FALSE CLAIMS FUROR: The government’s intervention in this action is part of the government’s emphasis on combating health care fraud and another step for the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative.
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Key Facts
- State: Federal
- Category: Whistleblower | False Claims Act | Healthcare Fraud | Medicare
- Source: DOJ Press Release ↗
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