Eden Prarie, Minn.-based Evercare Hospice and Palliative Care, now Optum Palliative and Hospice Care, will pay $18 million to resolve allegations that it claimed Medicare reimbursement for hospice care for patients who were not terminally ill, according to the Department of Justice.
A lawsuit brought by the government alleges that Evercare knowingly submitted false claims to Medicare for hospice care from 2007 to 2013 for patients that were not terminally ill and ineligible for Medicare hospice benefit.
The complaint also alleges that Evercare officials knowingly discouraged physicians from recommending that ineligible patients be discharged from hospice and failed to ensure that nurses accurately documented patients' conditions.
The allegations arose from whistleblower lawsuits filled by former Evercare employees under provisions of the False Claims Act.
The settlement marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team, a joint initiative launched by the Attorney General and the Secretary of HHS in 2009. Since it's creation, the Justice Department has recovered more than $30 billion in False Claims cases. More than $18.3 billion of that amount was recovered in cases involving fraud against federal healthcare programs.
More articles about legal & regulatory issues:
NY state sues Armor Correctional Health Services over 12 inmate deaths
No mistrial for University of Chicago Medical Center $53M in birth injury lawsuit
Ex-CEO of defunct Long Beach substance abuse center indicted for $50M fraud scheme