DOJ intervenes in Alabama hospice whistleblower suit

by Ben Vernia | January 3rd, 2012

On January 3, the Department of Justice announced that it was intervening in a qui tam suit brought by two former employees of an Texas-based hospice chain, AseraCare Hospice. According to DOJ’s press release:

The United States has intervened and filed a complaint in a whistleblower suit against AseraCare Hospice, the Justice Department announced today. Golden Gate Ancillary LLC, dba AseraCare Hospice, is a for-profit business with approximately 65 hospice providers in 19 states, including Alabama, Georgia, Pennsylvania and Wisconsin. In its complaint, filed in U.S. District Court for the Northern District of Alabama, the government alleges that AseraCare violated the False Claims Act when it misspent millions of taxpayer dollars intended for Medicare recipients who have a prognosis of six months or less to live and need hospice care.

While elderly patients may qualify for a variety of other medical services paid by Medicare, for-profit hospice companies like AseraCare are entitled to receive Medicare dollars only for Medicare recipients who are terminally ill. When a business admits a Medicare recipient to hospice care, that individual is no longer entitled to receive services that would help to cure his or her illness. Instead, the individual receives what is called palliative care, or care that is aimed at relieving pain, symptoms or stress of terminal illness, which includes a comprehensive set of medical, social, psychological, emotional and spiritual services. In this lawsuit, the government contends that AseraCare Hospice knowingly submitted false claims to Medicare for hospice care for patients who were not terminally ill.

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