Eli's Hospice Insider

Published on Tue Feb 14, 2012 PDF

The feds have their eye on hospice upcoding. The owner of a hospice in Muscle Shoals, Ala., has pled guilty to Medicare fraud and received a prison sentence of 28 months. He also must forfeit nearly $3.2 million to the government.

Jackie Randolph Gist caused Good Samaritan Hospice USA Inc. to submit claims for General Inpatient Care when GSH actually provided routine home care, says the U.S. Attorney's Office for the Northern District of Alabama. "As a result of the scheme, GSH received reimbursements from Medicare totaling $4,108,924 when, if the correct code had been used, GSH would have been reimbursed $916,639," the release explains.

"This office will not tolerate such fraud and remains committed to aggressively prosecuting individuals and companies that seek to steal from government programs," U.S. Attorney Joyce White Vance says in the release.