Giant Hospice Chain Accused of Medicare Fraud

KANSAS CITY, Mo. (CN) – Vitas Healthcare, the largest profit-seeking hospice chain in the country, defrauded Medicare of tens of millions of dollars, the United States claims in Federal Court.
     Vitas Healthcare Corp., Vitas Hospice Services and affiliates defrauded Medicare for nearly a decade by submitting claims for crisis care that was not needed and/or not provided, prosecutors say in the complaint.
     Also sued is Vitas’ corporate parent, Chemed Corp., of Cincinnati, which owns Roto-Rooter. Chemed bought Vitas in 2004. It provides hospice care in 18 states and the District of Columbia.
     The 51-page complaint describes Vitas’ allegedly fraudulent bills as high as $170,000 apiece for numerous patients. For instance, Vitas billed Medicare for $169,821 for a woman (MC) it diagnosed with “heart failure,” though “MC had no symptoms to indicate MC had any end-stage disease or condition, including heart disease. At the time of MC’s admission to the hospital, MC was living independently and performing daily activities without assistance,” the complaint states.
     It continues: “At around the time Vitas admitted MC to its hospice program, its medical notes for MC stated that MC was ‘very healthy given her age.’ In fact, Vitas stopped administering MC heart medications during her time in hospice.”
     “The companies set goals for the number of crisis care days that were to be billed to Medicare,” the U.S. Attorney’s Office said in a statement. Prosecutors said in the statement that Vitas “used aggressive marketing tactics and pressured staff to increase the numbers of crisis care claims submitted to Medicare, without regard to whether the services were appropriate or were actually being provided. For example, the complaint contends that Vitas billed three straight days of crisis care for a patient, even though the patient’s medical records do not indicate that the patient required crisis care and, indeed, reflect that the patient was playing bingo part of the time.”
     Prosecutors add: “Chemed and Vitas knowingly submitted or caused the submission of false claims for hospice care for patients who were not terminally ill. The companies allegedly paid bonuses to staff based on the number of patients enrolled in the program and based on patients who were admitted for longer lengths of stay, and took adverse employment actions against marketing representatives who did not meet monthly hospice admissions goals. According to the complaint, these business practices resulted in the admission of patients who were not eligible for hospice care.”
     The United States seeks tens of millions of dollars in restitution, statutory damages and treble damages under the False Claims Act. It claims to have recovered $10.3 billion from health care fraudsters since President Obama took office.

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