Hospice of the Comforter, Inc. (HOTCI) agreed to pay $3 million to resolve allegations that it violated the False Claims Act (FCA) by submitting false claims to the Medicare program for hospice services provided to patients who were not eligible for the Medicare hospice benefit. HOTCI did not admit any liability in the settlement. The settlement resolves a qui tam action brought by a former HOTCI employee. United States ex rel. Stone v. Hospice of the Comforter Inc., No. 6:11-cv-1498-ORL-22-DAB (M.D. Fla. Oct. 28, 2013).
In his lawsuit, the former employee alleged HOTCI:
- directed its staff to admit all referred patients without regard to whether they were eligible for the Medicare hospice benefit;
- falsified medical records to make it appear that certain patients were eligible for the benefit when they were not;
- employed field nurses without hospice training;
- established procedures to limit physicians’ roles in assessing patients’ terminal status; and
- delayed discharging patients when they became ineligible for the benefit.
While it did not admit any liability, as part of the settlement, HOTCI entered into a Corporate Integrity Agreement with the Department of Health and Human Services that provides for procedures and reviews to be put in place to promptly detect and prevent future conduct similar to that which gave rise to the settlement.