WASHINGTON—Hospice Care of Kansas LLC
and its parent company, Ft. Worth, Texas-based Voyager HospiceCare Inc., have
agreed to pay $6.1 million to resolve allegations that they violated the False
Claims Act by submitting claims to the Medicare program for ineligible hospice
services, the Justice Department announced today. Hospice Care of Kansas
currently provides hospice services throughout the state of Kansas. Hospice
Care of Kansas, which is based in Wichita, Kansas, was purchased by Voyager in
2004.
The Medicare hospice benefit is
available for patients who elect palliative treatment (medical care focused on
providing patients with relief from the symptoms, pain, and stress of a serious
illness) for a terminal illness and who have a life expectancy of six months or
less if the disease runs its normal course. Today’s settlement resolves
allegations that Hospice Care of Kansas and Voyager submitted or caused the
submission of false Medicare claims between January 2004 and December 2008 for
beneficiaries that did not have a terminal prognosis of six months or less.
The government alleged that Hospice Care
of Kansas and Voyager engaged in certain practices that resulted in the
submission of false claims, including the provision of compensation to clinical
employees based on patient census and admissions, delaying discharges of
patients determined not to have a six month or less prognosis, instructions to
staff to document patient conditions in a misleading manner, and implementation
of an inadequate compliance program.
“The Medicare hospice benefit is
intended to provide comfort and care to terminally ill persons in the final
stages of their disease,” said Stuart F. Delery, Acting Assistant Attorney
General for the Department of Justice’s Civil Division. “This settlement shows
that the Department of Justice will not tolerate hospice providers that attempt
to maximize their profits at the expense of their legal and ethical obligations
to the Medicare program, taxpayers, and beneficiaries.”
“Our goals are to protect taxpayer
dollars, ensure the viability of government health care programs, and
strengthen our national health care system,” said Barry Grissom, U.S. Attorney
for the District of Kansas. “This case is a step in that direction.”
“We expect providers of Medicare
services to operate with the utmost integrity and with the best interests of
our beneficiaries in mind. Working with our partners at the Department of
Justice, we will hold those accountable who do not operate in this manner,”
said Gerald Roy, Special Agent in Charge, U.S. Department of Health and Human
Services, Office of Inspector General.
The allegations that are the subject of
today’s settlement were originally raised in a lawsuit filed by a former Hospice
Care of Kansas nurse, Beverly Landis, under the qui tam, or whistleblower,
provisions of the False Claims Act. The act allows private citizens with
knowledge of fraud to bring an action on behalf of the United States and share
in any recovery. As a part of today’s resolution, Ms. Landis will receive
payments totaling $1.342 million.
This resolution 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,
which was announced by Attorney General Eric Holder and Kathleen Sebelius,
Secretary of the Department of Health and Human Services, in May 2009. The
partnership between the two departments has focused efforts to reduce and
prevent Medicare and Medicaid financial fraud through enhanced cooperation. One
of the most powerful tools in that effort is the False Claims Act, which the
Justice Department has used to recover more than $7.7 billion since January
2009 in cases involving fraud against federal health care programs. The Justice
Department’s total recoveries in False Claims Act cases since January 2009 are
over $11.3 billion.
The investigation was jointly handled by
the Justice Department’s Civil Division, the FBI, the Office of the Inspector
General of the Department of Health and Human Services, and the U.S. Attorney’s
Office for the District of Kansas. The claims settled by this agreement are
allegations only, and there has been no determination of liability.
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