A settlement has been reached to resolve False Claims Act Allegations against Evercare Hospice and Palliative Care.
The allegations arose by a lawsuit claiming Evercare Hospice and Palliative Care claimed Medicare reimbursement for hospice care for patients who were not eligible for such care because they were not terminally ill.
According to the government, Evercare intentionally submitted false claims to Medicare for hospice care from January 1, 2007, through December 31, 2013, for Medicare patients who were not eligible for the Medicare hospice benefit because Evercare’s medical records did not support that they were terminally ill. Allegedly, Evercare’s business practices were designed to maximize the number of patients for whom it could bill Medicare without regard to whether the patients were eligible for and needed hospice. These business practices allegedly included discouraging doctors from recommending that ineligible patients be discharged from hospice and failing to ensure that nurses accurately and completely documented patients’ conditions in the medical records.
“Hospice care is only medically necessary and reimbursable by Medicare for terminally ill patients with a life expectancy of six months or less,” said Special Agent in Charge Steven Hanson of the Department of Health and Human Services’ Office of Inspector General (HHS-OIG). “We will continue to vigorously investigate health care companies that put their own profits above the medical needs of patients to ensure that companies bill Medicare only for reimbursable health care services.”
The allegations resolved by this settlement arose from whistleblower lawsuits initially filed by former employees of Evercare.
