Hospice Care Fraud Attorney in Atlanta

If you know about a hospice provider that is falsely certifying patients for hospice care , you can use the False Claims Act to stop the fraud. Under the FCA, whistleblowers can do the right thing . To encourage people to come forward, the Act says that a successful whistleblower is entitled to get 15%-30% of all the money that the Government collects from an end-of-life care provider. Whistleblowers have been paid millions of dollars for their help in recovering the massive sums that the Government has lost to hospice care fraud. You stand to gain as well by reporting the fraud.

Lee Wallace at The Wallace Law Firm, LLC graduated with honors from Harvard Law School, and Georgia lawyers have voted her one of the state’s Super Lawyers® every year since the poll began. She has handled legal matters in twenty states, and represents whistleblowers on a nationwide basis.

Talk to Lee Wallace at our firm about your case.

How Hospice Care Fraud Works

Hospice care is a medical program that provides comfort and care for patients who are terminally ill. The program is supposed to be a short-term program that is only available for patients who are in the last six months of their lives. For that reason, the Medicare regulations limit the term of care. The care can be extended if providers certify that the patient continues to qualify for the care.

However, some unscrupulous hospice providers have been gaming the system. Since Medicare reimburses hospice care providers a flat fee for each day they “care for” the patient, these healthcare providers have figured out that the less care they have to give, the more profit they make. These fraudsters are admitting patients who are not truly eligible for the program because they are too healthy and will live much longer than six months. These patients, because they are not truly at the end of life stage, are more profitable because they require far less care than patients who really need Hospice.

What Will Happen If We Don’t Stop Hospice Fraud?

Hospice fraud endangers the medical care system for other Medicare patients: “The hospice industry relies on the Medicare Trust Fund, and payments for unnecessary services jeopardize its financial viability,” said U.S. Attorney for the District of Maryland Rod J. Rosenstein, quoted in Hospice of Arizona and Related Entities Pay $12 Million to Resolve False Claims Act Allegations .

To stop hospice fraud, whistleblowers must file a lawsuit under the FCA. But you need representation for an attorney who specifically handles whistleblower claims. At The Wallace Law Firm, LLC, Lee Wallace dedicates her entire practice to whistleblower law. She graduated first in her class at Vanderbilt University. Georgia Trend magazine has called her one of Georgia’s “Legal Elite”. Attorney Wallace is a name you can trust in whistleblower advocacy.

Whistleblowers Recover Millions In Hospice Fraud Cases

Here are some examples of cases where a whistleblower exposed hospice care fraud:

  • Whistleblower Ellen Momeyer filed a False Claims Act suit against her former employer, Hospice of Arizona, L.C., and American Hospice Management, LLC. She blew the whistle on the company, which was making false certifications that patients were eligible for hospice care and billing Medicare at a higher reimbursement rate than it should have. Hospice of Arizona and American Hospice agreed that they would pay the Government $12 million to settle the False Claims Act case allegations. Momeyer received $1.8 million for her work in helping the United States recover this money that it had lost due to fraud.
  • Hospice Care of Landis paid the U.S. $6.1 million to settle similar allegations. The whistleblower in that case was paid $1.342 million.
  • In January 2013, Harmony Hospice Care, Inc. of South Carolina and its owner settled an FCA case in which they were accused of billing Medicare for patients the company knew were not legitimately at the end stages of a terminal illness. The Government received $1.287 million, and the whistleblower was paid $224,529.87 of that amount.
  • In July 2012, the Atlanta office of the U.S. Attorney of the Northern District of Georgia announced a settlement with Altus Healthcare & Hospice Inc. The company paid the Government $555,572, and part of that amount was paid over to the whistleblower who had filed suit and brought the facts to the attention of the Government.

Hospice Medicare fraud is one of the most troubling areas of healthcare fraud today. If you know about fraud involving end-of-life care, discuss your concerns with an attorney and learn how you should proceed.

Contact a hospice care fraud lawyer today at (404) 550-4615.