Vitas Healthcare hospice provider pays $75 million to settle False Claims Act case of Medicare fraud

Vitas Healthcare, a major hospice provider has agreed to pay $75 million to settle a False Claims Act case charging the company inflated charges and overbilled taxpayers.

“Today’s resolution represents the largest amount ever recovered under the False Claims Act from a provider of hospice services,” said Acting Assistant Attorney General Chad A. Readler of the U.S. Justice Department’s civil division.  “Medicare’s hospice benefit provides critical services to some of the most vulnerable Medicare patients, and the Department will continue to ensure that this valuable benefit is used to assist those who need it, and not as an opportunity to line the pockets of those who seek to abuse it.”

In 2012, the for-profit Vitas, billed the government for patient stays in Palm Beach County that averaged 40 percent longer than those of non-profit competitors. The newspaper also showed hospice services were being marketed at assisted-living facilities as a service for people who might not necessarily die — or even get better — though federal law required a diagnosis of six months or less to live. The Justice Department filed a complaint under the False Claims Act alleging Vitas defrauded Medicare by charging for people who were not terminally ill and sending “crisis care” bills for patients that nurses said were at church, bingo or the beauty parlor.

The settlement walso resolves three lawsuits filed under the whistleblower provision of the False Claims Act, which permits private parties to file suit on behalf of the United States for false claims and share in a portion of the government’s recovery. Hospice care was originally createdto provide pain control and other “palliative” care for those diagnosed with terminal illness, with the idea of making them as comfortable and peaceful as possible if they chose not to pursue costly or painful last-ditch attempts to cure a disease. A hospice can refer to a building, though most patients receive care in their homes or in nursing or assisted-living facilities.

Jeffrey Newman represents whistleblowers