U.S. sues hospice company for wrongly billing Medicare

chicagotribune.com


U.S. sues hospice company for wrongly billing Medicare

Reuters
5:02 PM CST, January 3, 2012


WASHINGTON (Reuters) - The U.S. Justice Department accused privately held hospice care provider AseraCare Hospice of wrongly getting millions of dollars by making false claims to the Medicare federal healthcare program.

AseraCare, which is owned by Golden Living Communities, was accused of filing Medicare claims for patients who were not terminally ill, even though the program does not allow reimbursements for those who do not have a prognosis of six months or less to live.

"The United States alleges that AseraCare, through its reckless business practices, admitted and retained individuals who were not eligible to receive Medicare hospice benefits," according to the complaint filed in federal court on Tuesday.

"AseraCare misspent millions of Medicare dollars intended for Medicare recipients who have a prognosis of six months or less to live and need hospice care," the government said.

The Justice Department lawsuit joins a whistleblower suit filed in 2009 by former employees. The company has about 65 hospice providers in 19 states.

The company said the allegations were without merit and noted that the U.S. Department of Health and Human Services has allowed hospice patients to stay under such care without limit as long as they are terminally ill and have a six-month prognosis.

"This action is especially troubling because we believe it could constrain certain patients - most notably those who suffer from unpredictable disease - from utilizing the hospice benefit," said AseraCare general counsel David Beck.

The case is United States ex rel. Richardson and Brown v. Golden Gate National Senior Care LLC dba Golden Living et al, No. 2:09-cv-00627, in U.S. District Court for the Northern District of Alabama.

For Richardson: Henry Frohsin of Frohsin & Barger.

For Golden Gate: Not immediately available.
(Reporting by Jeremy Pelofsky)

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http://www.chicagotribune.com/health/sns-rt-us-healthcare-hospicetre8021uq-20120103,0,3311310.story

Editor's note:  Your ProbateShark filed a complaint with DOJ for the Estate Of Alice R. Gore, deceased, a disabled 99 year old ward of the Probate Court of  Cook County, Judge Kawamoto's courtroom.  Alice was charged 6 times for the same X-ray while at a Chicago nursing home. Even after Alice's daughter complained to the nursing home, the bill was still paid. Maybe an fraudulent charge of $850.00 is to small for the DOJ to bother with. Lucius Verenus, Schoolmaster, ProbateSharks.com

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