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Jan 2, 2022 by |

Marin County Elder Abuse And Whistleblower Attorney: Hospice Agency Pays $5.5 Million To Settle False Claims Act Liability

ATTORNEY NEWSLETTER

Ineligible Certifications Of Hospice Patients

Alleged Payments For Non-Terminally Ill Patients

Three Former Employees And Physician Blow Whistle

Healthcare fraud against government programs like Medicare costs taxpayers billions every year.  Private persons with knowledge of such fraud can bring a whistleblower suit (known as a qui tam action) under the federal False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq., to recover government funds paid out on fraudulent claims.  The FCA offers sizeable awards to whistleblowers.  31 U.S.C. § 3730(d).  When the targeted patients of healthcare fraud are elders, such fraud cases may also constitute elder abuse under the California Elder Abuse and Dependent Adult Protection Act, Cal. Welf. & Inst. Code § 15600 et seq.  Medicare fraud often overlaps with elder abuse in hospice programs, nursing homes and assisted care facilities where the elderly patient, as well as the government, is harmed or defrauded by the misconduct of the care provider. Evans Law Firm, Inc. represents California seniors who have suffered elder abuse and individuals with credible information of fraud against government-sponsored healthcare programs. If you have credible information of elder abuse and healthcare fraud in Marin County, San Francisco, or elsewhere in California, call us today at (415)441-8669 and we can help. Our toll-free number is 1-888-50EVANS (888-503-8267).

Hospice Agency Settles False Claims Act Allegations

The U.S. Department of Justice (DOJ) recently announced a $5.5 million settlement with a hospice agency of False Claims Act allegations of billing the government’s Medicare program for hospice services for patients who were not terminally ill and thus not eligible for hospice care.[1]  The settlement resolved allegations that a hospice program knowingly submitted false claims to Medicare for hospice services for patients who were not terminally ill.  Hospice care is special, end-of-life care intended to comfort terminally ill patients. Patients admitted to hospice care generally stop receiving coverage for traditional medical care designed to cure their terminal condition and instead receive medical care focused on providing them with relief from the symptoms, pain and stress of a terminal illness. Medicare patients are considered to be terminally ill and hospice-eligible when they have a life expectancy of six months or less if their illness runs its normal course.  According to the settlement agreement, the United States alleged that for a period of three years, the defendant  billed Medicare for hospice care for certain patients with a diagnosis of dementia or Alzheimer’s disease who were not terminally ill for at least a portion of the more than three years that the patients received care at agency locations. The allegations were asserted in two qui tam actions brought by three former employees and a physician with knowledge of the allegedly fraudulent claims.  The whistleblowers will share a reward of $1,045,000.

False Claims And Elder Abuse

Patients and employees may have information of abuse and government fraud.  Evans Law Firm, Inc. will pursue all available remedies to any plaintiffs injured by abuse or impacted by fraud.  If you are an employee with information of healthcare fraud, federal law protects you from retaliation by your employer from bringing a qui tam case.  31 U.S.C. § 3730 (h).  Despite the legal protection, employers continue to retaliate against whistleblowers.  The law allows you to fight back and you may be entitled to sue your employer in court and seek double back pay (with interest), reinstatement, reasonable attorneys’ fees, and reimbursement for certain costs in connection with the litigation. 31 U.S.C. § 3730(h)(2).  Evans Law Firm, Inc. can represent you in any action for retaliation as well as represent you in your underlying whistleblower application.

Contact Us

If you have credible information of fraud against government healthcare programs in Marin County, San Francisco or elsewhere in California, call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>.  In addition to FCA whistleblower cases, Ingrid also handles bank fraud whistleblower cases under FIRREA/FIAFEA, commodity trading and securities fraud under the Commodities Futures Trading Commission Whistleblower Program and the Securities and Exchange Commission Whistleblower Program, and tax fraud under the Internal Revenue Service Whistleblower Program. 

[1] Evans Law Firm, Inc. was not involved in the cases in any way.  The qui tam cases are: United States ex rel. Leanne Malone et al. v. Carrefour Associates LLC et al., No. 1:15-cv-460 (S.D. Ohio) and United States ex rel. David Weber v. Crossroads Hospice of Tennessee, LLC, No. 2:16-cv-02684 (W.D. Tenn.). 

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