Hospice provider hit with Medicare fraud suit

A whistleblower lawsuit unveiled last week and joined by the U.S. government accuses a Texas-based hospice provider of cycling patients as much as possible in order to maximize Medicare payments, reported Kaiser Health News. According to the suit, AseraCare pressured its employees to enroll non-terminal patients into hospice and keep them there despite no deterioration of their medical condition.

Most transfers were made after a patient spent 20 days in a nursing facility, at which point Medicare paid significantly less for care. Flat payments for hospice care have far fewer limitations, notes the article.

The company is owned by Golden Living, a nationwide operator of skilled nursing services, reported the San Francisco Chronicle.

"Typically, a patient admitted into Defendant's web of operations will be referred and re-referred until that patient has received-and Medicare has been billed for-the maximum number of days of skilled nursing care, including rehabilitative therapy ... home health care, and hospice care," said the lawsuit, filed by an Asera nurse manager and office manager.

The Medicare hospice benefit has come under fire as being ripe for abuse. According to the federal lawsuit, some AseraCare patients who should have been rendered immobile by their medical conditions were able to attend their grandchild's graduation and other outings, noted KHN.

AseraCare said it would vigorously fight the lawsuit.

To learn more:
- read the Kaiser Health News article
- read the San Francisco Chronicle article

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