Eli's Hospice Insider

Published on Mon Apr 15, 2013 PDF

Tip: Provide your employees with a place to report concerns, before they become whistleblowers.

Hospice isn’t usually the first provider type that springs to mind when the topic of fraud and abuse is broached. But that may change, if more cases like the one involved in a recent whistleblower suit surface.

Hospice of Arizona, related entity American Hospice Management, and their parent corporation, American Hospice Management Holdings, have agreed to settle False Claims Act allegations for $12 million. AHMH also will enter into a corporate integrity agreement with the HHS Office of Inspector General.

The charges were brought in a whistleblower suit by former employee Ellen Momeyer, who will receive $1.8 million as part of the settlement, the Department of Justice says.

“The government alleged that Hospice of Arizona and its related entities, engaged in certain practices that resulted in the admission of ineligible patients or inflated bills,” the DOJ says. The practices included “pressuring staff to find more patients eligible for Medicare, adopting procedures that delayed and discouraged staff from discharging patients from hospice when they were no longer appropriate for such services, and not implementing an adequate compliance program that might have addressed these problems.”

Do this: As part of your corporate compliance program, provide your employees with a place to report concerns before they become whistleblowers, legal experts advise.