American Hospice Management Holdings LLC, headquartered in Jacksonville, Florida, and two of its subsidiaries, Hospice of Arizona, L.C. and American Hospice Management, LLC, (collectively “American Hospice”) have agreed to settle charges that they violated the federal False Claims Act.
According to American Hospice’s website, it is the oldest hospice management company in the United States. It manages hospice companies in Arizona, Oklahoma, Georgia, New Jersey, Virginia, Texas and Pennsylvania.
For-profit hospice providers, such as American Hospice, can only receive Medicare funds for Medicare recipients with a prognosis of six months or less to live. When a Medicare recipient is admitted to hospice care, that patient is no longer entitled to receive medical treatment intended to cure his or her illness. Instead, patients in hospice receive care that is intended to relieve pain, symptoms and the stress of terminal illness.
A whistleblower complaint was filed by former Hospice of Arizona employee Ellen Momeyer under the qui tam provisions of the False Claims Act in 2010. In the complaint, the whistleblower alleged that between September 1, 2002 and December 31, 2010, American Hospice submitted false claims to Medicare for patients who were not eligible for hospice care or billed Medicare at a higher rate than it was entitled.
After intervening in the qui tam suit, the government alleged that American Hospice encouraged the admission of ineligible Medicare patients and the submission of inflated bills by pressuring staff to find more Medicare patients and discouraging the discharge of Medicare patients that were no longer suitable for hospice care.
The American Hospice entities have agreed to settle the charges for $12 million. The whistleblower will receive $1.8 million of the settlement amount as her reward under the qui tam provisions of the False Claim Act.