Consumer Fraud

U.S. joins whistleblower lawsuit against hospice provider for Medicare fraud

osha whistle U.S. joins whistleblower lawsuit against hospice provider for Medicare fraudThe federal government is joining a whistleblower lawsuit filed by a California physician under the False Claims Act (FCA) against the largest for-profit hospice provider in the United States. The lawsuit accuses Chemed Corp.’s Vitas Healthcare of certifying patients as eligible for hospice so it could receive money from Medicare for unneeded hospice services.

The whistleblower complaint was filed by Dr. Charles Gonzalez, who worked for Vitas in Los Angeles from 2004 to 2011. Dr. Gonzalez accuses the company of “padding its profits at the expense of taxpayers” for deliberately providing hospice care to patients who didn’t qualify.

“Many of these patients remain on hospice care for years with little or no decline in health and require little in resources from Vitas,” Gonzales asserts in his lawsuit. Hospice care is intended for patients who have six months or less to live if their terminal illness runs its normal course.

Vitas Healthcare operates in 18 states (Alabama, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kansas, Michigan, Missouri, New Jersey, Ohio, Pennsylvania, Texas, Virginia and Wisconsin) and the District of Columbia. According to its website, the company provided more than 5.1 million days of hospice care in 2012.

The U.S. Justice Department has made similar allegations against Chemed and Vitas in its own lawsuit, which accuses the companies of making false claims to Medicare. Federal officials said that the U.S. seeks to consolidate its complaint with the one filed by Dr. Gonzalez, which was transferred to a federal court in Kansas City, Mo. The U.S. complaint alleges Vitas Healthcare units in California, Florida, and Illinois routinely defrauded Medicare.

In the complaint he filed on behalf of the U.S. government, Dr. Gonzalez seeks civil penalties of $10,000 for each of three alleged false claims he documented, plus triple the amount of damages sustained by the federal government’s Medicare program.

The False Claims Act allows private citizens to file a lawsuit on behalf of the United States when they believe they have witnessed private companies of committing fraud, waste, mismanagement, and other wrongdoing. Under the Act’s qui tam provision, whistleblowers who sue for the U.S. can receive a percentage of the recovery.

Sources:

U.S. Justice Department
Bloomberg