Enrollment Fraud and unjustified stays in hospice are by far the most common and widespread violation in Florida.
In 2013 HPH Hospice (Hernando-Pasco Hospice) a Florida nonprofit corporation that provided hospice services throughout Hernando, Pasco, and Citrus counties agreed to pay $1 Million dollars to resolve claims that it knowingly encouraged improper admittance and submitted false Medicare / Medicaid claims for patients who did not actually need end of life care. Defendants allegedly had employees accept patients who did not need hospice care in order to meet goals set by management, failed to implement compliance programs, created procedures to discourage staff from discharging patients and instructed employees to falsify medical records all with the aim of admitting and extending stays for patients who did not need end-of-life care.
Also in 2013 Hospice of the Comforter Inc. (HOTCI) operating in Seminole, Osceola and Orange counties agreed to pay $3 million to resolve allegations that it knowingly submitted false claims to Medicare for patients who were not eligible for end-of-life care. In this case the whistleblower complaint alleged that the defendant directed employees to blindly admit all referred patients regardless of whether or not they were eligible for end of life care, falsified medical records to make patients appear to be eligible, delayed discharging patients and even established procedures to limit doctors roles in assessing patients terminal status.
In 2017 Haven Hospice, headquartered in Gainseville, FL, agreed to a more than $5 million settlement to resolve claims that it knowingly billed the federal government for medically unnecessary and undocumented hospice services. The hospice allegedly knowingly or recklessly failed to show valid reasons for patients’ initial hospice admittance and continued to collect medicare payments throughout their stay despite patients failure to show a decline in health. Haven retained some 63 patients who showed no signs of decline for three years and some patients up to six years.
Most recently in 2018, Health and Palliative Services of the Treasure Coast, Inc., The Hospice of Martin and St. Lucie, Inc., and Hospice of the Treasure Coast, Inc. agreed to pay $2.5 million dollars to settle allegations that they knowingly submitted false claims for services to hospice patients who were not terminally ill and were not eligible for such services under Medicare.