Ohio- and Tennessee-based hospice pays $5.5 million to settle whistleblowers’ fraud claims

by Ben Vernia | November 27th, 2021

On November 23, the Department of Justice announced that various Crossroad Hospice entities have agreed to pay $5.5 million to settle civil claims, originally brought by whistleblowers, that the Ohio and Tennessee hospices submitted fraudulent claims to federal healthcare programs. According to DOJ’s press release:

Carrefour Associates LLC; Crossroads Hospice of Cincinnati LLC; Crossroads Hospice of Cleveland LLC; Crossroads Hospice of Dayton LLC; Crossroads Hospice of Northeast Ohio LLC; and Crossroads Hospice of Tennessee LLC (Crossroads Hospice), operating in Ohio and Tennessee, have agreed to pay $5.5 million to resolve allegations that they violated the False Claims Act by submitting claims to Medicare for non-covered hospice services.

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.

This settlement resolves allegations that Crossroads Hospice knowingly submitted false claims to Medicare for hospice services for patients who were not terminally ill. According to the settlement agreement, the United States alleged that from Jan. 1, 2012 to Dec. 31, 2014, Crossroads Hospice billed Medicare for hospice care for certain patients with a diagnosis of dementia or Alzheimer’s disease at its Ohio and Tennessee locations who were not terminally ill for at least a portion of the more than three years that the patients received care at these locations.

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The Government did not announce the relators’ share of the settlement.

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