The U.S. government today unsealed a complaint filed in 2004 alleging overcharging of Medicare for hospice services by several hospices in Arkansas. It also announced that it would pursue civil action against the for-profit hospice operation alleged to have devised a scheme to overcharge for hospice services that included kickbacks to nursing homes.
The allegation was raised by Arkansas Hospice Inc., a competitor that operates a hospice in Little Rock. Its news release is on the jump. It could independently decide to pursue civil action itself against those the U.S. attorney has chosen not to pursuse, but has not yet made a decision whether to do so, its attorney Emily Sneddon said.
The U.S. attorney will file a civil action within 60 days against the for-profit Hospice Home Care and the related Hospice Home Care of Pine Bluff, which operate hospices in five cities, and three of the firm's officers.
The 2004 allegation said Hospice Home Care charged Medicare for acute care patients didn't need or receive. It also said Hospice Home care improperly solicited patients by promising free nursing home care. And it said it had induced nursing homes to cooperate by providing exorbitant reimbursement for nursing home services, including to one nursing home, Presbyterian Village, that didn't qualify for Medicare.
The U.S. attorney decided not to intervene against others named in the original complaint -- Barrow Road Care and Rehabilitation Center, which operates Parkview Rehabilitation and Health Care, and Presbyterian Village and its related Prebyterian Village Foundation.
In a news release, U.S. Attorney Jane Duke said no intervention was made in the case of the nursing homes because Parkview has filed bankruptcy and ceased operations and because Presbyterian Village admitted few patients and ceased its relationship with Hospice Home Care soon after the contracts were negotiated.
Duke said in a representative sample of 34 patients the government had found 257 false claims that represented at least $1.4 million in overpayments.
Here's a copy of the 2004 complaint.
Here's a copy of the U.S. attorney's intervention decision.
ARKANSAS HOSPICE NEWS RELEASE
The United States Attorney’s office has made public its investigation of Hospice Home Care, Inc. The investigation stemmed from the initiation of a qui tam or “whistleblower” action by the governing board of Arkansas Hospice in April 2004. Soon thereafter, the federal government investigated the allegations of the lawsuit. (A qui tam action is one initiated by a private party on behalf of the federal government that the government may later join in and take over and pursue on its own behalf.)
The board’s hope in filing this complaint was threefold: (1) to see that patients receive appropriate care no matter what hospice program cares for them; (2) to uphold the public trust in hospice care; and (3) to be assured the federal government would review the situation and respond as needed.
The U.S. Attorney’s office has decided to intervene and pursue the case. We are confident that the actions of the government in this matter will serve to uphold the quality of hospice care in Arkansas, and the community trust in hospice services.
Should the case be decided or settled in the government’s favor, any distribution to Arkansas Hospice for its help in this matter will be used to enhance hospice care in Arkansas. No one on the board or staff at Arkansas Hospice will personally benefit from this case.