Advanced Search

Medicare Compliance & Reimbursement

COMPLIANCE:

Ward Off Whistleblower Suits With These 4 Strategies

Published on Mon Jul 06, 2009

Cover your bases to head off qui tam suits. You may think you've got all the bases covered in heading off whistleblower lawsuits, but you shouldn't overlook the opposing team. Little Rock, Ark.-based for-profit Hospice Home Care Inc. (HHC) is learning that lesson the hard way, thanks to a qui tam suit filed by non-profit competitor Arkansas Hospice Inc., also of Little Rock. Arkansas Hospice filed the qui tam complaint in 2004, but the suit was just joined by the government and unsealed in federal court last month. In the original qui tam filing obtained by Eli, Arkansas Hospice alleges that HHC billed for patients who resided in nursing homes at the general inpatient (GIP) level when they really only qualified for -- and HHC only furnished -- routine hospice care. HHC used the GIP billing to tell patients and referral sources that the patients wouldn't have to pay for their nursing [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Medicare Compliance & Reimbursement

View All