Chemed Corp. and Vitas Hospice Services Agree to Pay $75M to Resolve False Claims Act Allegations

[nitpicker]

https://www.justice.gov/opa/pr/chemed-corp-and-vitas-hospice-services-agree-pay-75-million-resolve-false-claims-act

Department of Justice
Office of Public Affairs

FOR IMMEDIATE RELEASE
Monday, October 30, 2017

Chemed Corp. and Vitas Hospice Services Agree to Pay $75 Million to Resolve False Claims Act Allegations Relating to Billing for Ineligible Patients and Inflated Levels of Care

Chemed Corporation and various wholly-owned subsidiaries, including Vitas Hospice Services LLC and Vitas Healthcare Corporation, have agreed to pay $75 million to resolve a government lawsuit alleging that defendants violated the False Claims Act (FCA) by submitting false claims for hospice services to Medicare. Chemed, which is based in Cincinnati, Ohio, acquired Vitas in 2004. Vitas is the largest for-profit hospice chain in the United States.
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The settlement resolves allegations that between 2002 and 2013 Vitas knowingly submitted or caused to be submitted false claims to Medicare for services to hospice patients who were not terminally ill. Medicare’s hospice benefit is available for patients who elect palliative treatment (medical care focused on the patient’s relief from pain and stress) for a terminal illness and have a life expectancy of six months or less if their disease runs its normal course. Patients who elect the hospice benefit forgo the right to curative care (medical care focused on treating the patient’s illness). The government’s complaint alleged that Vitas billed for patients who were not terminally ill and thus did not qualify for the hospice benefit. The government alleged that the defendants rewarded employees with bonuses for the number of patients receiving hospice services, without regard to whether they were actually terminally ill and whether they would have benefited from continuing curative care.

The settlement also resolves allegations that between 2002 and 2013, Vitas knowingly submitted or caused to be submitted false claims to Medicare for continuous home care services that were not necessary, not actually provided, or not performed in accordance with Medicare requirements. Under the Medicare hospice benefit, providers may be reimbursed for four different levels of care, including continuous home care services. Continuous home care services are only for patients who are experiencing acute medical symptoms causing a brief period of crisis. The reimbursement rate for continuous home care services is the highest daily rate that Medicare pays, and hospices are paid hundreds of dollars more on a daily basis for each patient they certify as having received continuous home care services rather than routine hospice services. According to the complaint, the defendants set goals for the number of continuous home care days billed to Medicare and used aggressive marketing tactics and pressured staff to increase the volume of continuous home care claims, without regard to whether the patients actually required this level of crisis care.
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In addition to resolving the lawsuit filed by the United States, the settlement resolves three lawsuits filed under the whistleblower provision of the FCA, 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. The Act permits the United States to intervene in such a lawsuit, as it did in the three whistleblower cases filed against the defendants. These cases were subsequently transferred to the Western District of Missouri and consolidated with the government’s pending action. The amount to be recovered by the private whistleblowers has not yet been determined.
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[mucifer]

1. I worked as a nurse for a small non profit hospice during those years. We struggled with

nursing home referrals because vitas would provide continuous care when we wouldn't. Our CEO told us what vitas was doing was illegal. The nursing homes and patient's families loved vitas because their patients got around the clock care when they were dying but their symptoms were well managed.

This went on for several years. I'm pretty sure it was more than 10 years ago she told us that. She told us the government was investigating vitas and it was hard for me at times to believe anything was going to happen to them. I'm glad they finally are paying and I hope the fine is high enough to stop them.

Meanwhile our small non profit in a big city hospice got bought out by a larger non profit hospice so we could survive and we definitely have a more for profit feel to our company.