Feds charge three more Passages Hospice employees with fraud
By Kristen Schorsch
May 23, 2014
May 23, 2014
Health Care Headlines
Three more high-level employees at now-shuttered Passages Hospice LLChave been charged with defrauding the federal government.
In addition to Seth Gillman, the Passages administrator who founded the company in 2005, the U.S. Attorney's office has charged Gwen Hilsabeck, who served as co-administrator; Carmen Velez, director of nurses for a region that included Chicago and nearby suburbs, and director of clinical services; and Angela Armenta, director of certified nursing assistants for the region that included Chicago and nearby suburbs, according to an indictment filed yesterday in the U.S. District Court of the Northern District.
They're accused of submitting false claims to the U.S. Centers for Medicare and Medicaid Services and the Illinois Department of Healthcare and Family Services, which administers the Medicaid program in the state, for medically unnecessary hospice care, mainly for patients who were not terminally ill or did not qualify for inpatient care. In some cases, they submitted claims for services that weren't provided.
The alleged scheme happened from August 2008 to January 2012 and led Medicare, via a contractor, to pay Lisle-based Passages more than $90 million for hospice care, including more than $20 million for services that were billed as general inpatient services, according to the indictment.
“The indictment's unfortunate, and I fully expect at the end of this whole process, he'll be exonerated,” said Ed Genson, a Chicago attorney who is representing Mr. Gillman.
Mr. Gillman was the only person charged in January, though other unnamed people were alleged to have been involved. In February, Passages abruptly closed. Michael Gillman, Seth Gillman's father and the acting administrator, said at the time that the facility mainly operated on Medicare and Medicaid funding. The money had dried up since his son's charges, Michael Gillman said in February.
Passages offered care in four states, with the bulk of services provided in Illinois. It treated more than 800 patients a year.
Mr. Gillman, Ms. Hilsabeck and Passages, charged as a business, allegedly paid bonuses to nursing directors and certified nursing assistant directors, including Ms. Velez and Ms. Armenta, to increase the number of patients who were on general inpatient care, the indictment said. It also alleged Mr. Gillman, Ms. Hilsabeck and Passages offered incentives, such as payments to nursing homes based on the number of patients on general inpatient care, to increase Passages' patient census.
Each defendant allegedly altered, or caused to be altered, patient files to “conceal the scheme” from a Medicare auditor, the indictment alleged.
Mr. Gillman is charged with health care fraud and conspiracy to defraud the United States. Ms. Hilsabeck is charged with health care fraud, false statements relating to health care matters and conspiracy to defraud the United States. Passages Hospice LLC is charged with health care fraud and conspiracy to defraud the United States. Ms. Velez is charged with health care fraud and conspiracy to defraud the United States, and Ms. Armenta is charged with health care fraud
Ken Ditkowsky
