Hospice Fraud
Information about Fraud in Hospice and how to Protect and Advocate for Patients

Five Ways Hospice Providers Use Terminally Ill Patients to Rip Off Taxpayers

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Category: Uncategorised
Published: 13 September 2019

Article from: https://www.kellergrover.com

Feb 03 2017

Hospice care is the provision of specialized palliative treatment for terminally ill patients, focused not on curing them but making their last days as comfortable as possible. Hospice has gone from a grassroots movement on the outskirts of the U.S. medical establishment to a massive, multibillion-dollar industry. And as it has come of age, it has increasingly attracted the same type of fraud, waste, and abuse that plagues U.S. healthcare at large.

Hospice treatment has been covered by Medicare has since 1982, and its utilization has grown by leaps and bounds in recent years as for-profit providers have poured into the market: Almost half of all Medicare recipients who died in 2013 utilized hospice care. That year, 85 percent of the 1.5 million to 1.6 million patients who received hospice care had their treatment paid for by Medicare—to the tune of $15.1 billion.

Hospice can offer an appealing business opportunity because making a patient’s final days more comfortable is less complex than trying to cure a disease. Moreover, palliative care can be delivered anywhere—in hospitals, specialized hospice facilities, nursing homes, or even the patient’s own home. But it is also labor-intensive, meaning there isn’t much room to increase profits by improving efficiency. Moreover, Medicare’s reimbursement rates are calculated to guarantee hospice providers around a 6 percent return—not much of a profit. So making money becomes a volume game in which for-profit hospices push to serve more patients, deliver more treatments, or both.

Not surprisingly, then, much hospice fraud revolves around illegal schemes to obtain new patients or piling on medically unnecessary services. If hospice care follows the same pattern as Medicare as a whole, taxpayers may be losing upward of $1.4 billion annually to fraud, waste, abuse, and other “improper payments.”

The federal government is fighting back, and in 2015 it prosecuted more than 60 cases of hospice fraud worth hundreds of millions of dollars. The government relies heavily on whistleblower suits under the False Claims Act to be its eyes and ears in detecting these healthcare scams. Whistleblowers can be anyone who observe fraud, waste, or abuse against the government (like Medicare and other programs), and are often employees who witness or come to possess evidence of such conduct in their workplaces. Under the False Claims Act’s qui tam provisions, whistleblowers (called “relators” in False Claims Act parlance) can file suit on behalf of the United States and may be entitled to a share of money recovered.

Here are five ways unscrupulous hospice providers use and abuse Medicare, taxpayers, and the terminally ill. If you think you’ve encountered any of these, it may be worth consulting an attorney to see if you have a whistleblower case.

1. Can patients stay in hospice care even their prognosis changes to non-terminal?

There’s a reason that on average, for-profit hospices serve patients for nearly twice as many days as nonprofit hospices: Longer stays generally equal more money. It should be no surprise that the proportion of patients who were discharged alive from hospice care increased by around 50 percent between 2002 and 2012.

Sometimes patients enter hospice care with a terminal prognosis but their health subsequently improves. Instead of releasing such patients, the hospice falsely certifies that they’re still terminal and keeps them around. Medicare continues to pay its hospice per diem rate, while the costs associated with the patients drops off significantly because they no longer need palliative care.

But why wait for a patient’s prognosis to improve when you can just fill beds with healthy patients? The annals of whistleblower suits are replete with stories of just such scams. Owners of for-profit hospices put tremendous pressure on employees to “recruit” patients by any means necessary. The result is “dog-eat-dog, dirty, competitive fighting” for patients and the enrollment of people who may not have terminal illnesses—and who may not even be sick. One hospice marketer was allegedly caught on tape describing how salespeople would cruise neighborhoods to find patients. “How do you solicit patients? You see somebody sitting on the front porch in a wheelchair and you hit the brakes.”Medicare requires two doctors to determine a patient has less than six months to live before it will pay for hospice care. Clearly, any good scam requires doctors willing to lie or look the other way (or at least sign whatever is put in front of them).

2. Can hospice providers lawfully pay kickbacks for patient referrals?

“Kickbacks,” or payments in exchange for patient referrals, are illegal under Medicare rules. Still, providers may try to cover their tracks by disguising the kickbacks as payments for medical services or advising. Alternatively, providers may make kickback arrangements with nursing homes and other facilities. In any event, these types of payments are a form of healthcare fraud.

3. Classifying patients as needing higher levels of care than they actually do.

Even outside the hospice context, intentionally misclassifying patients is a common Medicare scam. A skilled nursing facilities will fraudulently put patients in the most intensive category so it can bill Medicare for their treatment at the “ultra-high” reimbursement rate; the parallel in the hospice world is “continuous” or “crisis” care, often reserved for patients in the last seven days of their lives.

The patients may simply need less care than would justify placing them in the crisis category. Or they may not need any care at all. In one case, the country’s biggest hospice company at the time was accused of billing Medicare for crisis care delivered during nurse visits to the homes of patients who were actually out “at church, at the beauty parlor, or playing bingo” when nurses arrived at their homes.

4. Providing more treatment than medically necessary.

Now we’re in territory where patients are actually being abused: providing medically unnecessary treatment. Overmedication is a common form of overtreatment in hospice fraud. It’s often done with painkillers, as palliative care is largely about pain management, and who’s going to notice if a terminally ill person in a lot of pain gets a few extra injections of morphine? How about one who isn’t in that much pain?

Intentionally giving someone unnecessary medicine or treatment is a crime, grounds for a tort lawsuit, and a major violation of medical ethics rules. And taxpayers foot the bill for all the unnecessary medication.

5. Pushing patients out of hospice in order to avoid aggregate caps — including allegedly “euthanizing patients for profits.”

Medicare limits the amount it pays hospices by imposing an “aggregate cap” on how much it will pay a hospice; determining the exact figure involves multiplying an “aggregate cap value” by the number of Medicare patients the hospice treats per fiscal year. (In 2016 the aggregate cap value was $27,820.75.) If a hospice exceeds its aggregate cap, it must refund the overage to Medicare. If this happens, the provider gets hit with a huge bill and once-profitable patients suddenly become liabilities, as every extra dollar of treatment is a dollar for which it will no longer be able to bill Medicare.

One hospice owner who was already running several scams expelled hundreds of patients when it learned it had exceeded its cap and it would have to repay millions of dollars. Horrifically, another owner who hit the cap allegedly “got rid of” at least four patients by ordering nurses to euthanize them with painkiller overdoses. He allegedly sent the “execution orders” by text message, and in one message told a nurse that “[y]ou need to make this patient go bye-bye.”

One patient died after being given at least 10 doses of morphine in a seven-hour window, “even though there was no documentation of pain or respiratory distress.”

There had apparently been “whispers” of this wrongdoing before the FBI got involved—exactly the kind of information that may well have been exposed by a whistleblower.

If you feel that you or someone you know may be a victim of hospice fraud, please contact our attorneys for a free and confidential consultation.

 

 

 

 

 

 

 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
 

 

 

Why the site HospiceFraud exists

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Category: Uncategorised
Published: 25 July 2018
  • hospice
  • fraud
  • indictment
  • medical fraud
  • execution
  • patients

The website Hospice Fraud exists not only because millions and millions of government dollars are being stolen by rogue hospices and their employees but also because of the enormous damage to American families, and all others who have been harmed by the theft of human life.  This behavior is against all values of our American system.  No where in any period of time has our country appeared to condone the degradation, the devaluation of human life as is taking place today. 

This is not a site that supports hospice haters.  This is a site that inspires solutions.  You can't totally eliminate care for the elderly, disabled or dying or you will just have euthanasia! You have to have some type of caring whatever you call it and originally hospice was the appropriate way of caring for people using the best of science to relieve suffering without killing.

Today, much greed in the industry and those who have found ways to make a lot of money off of human suffering have changed the landscape.  Hospice patients are simply a money crop.

One of the most blatant examples of this unacceptable and deplorable behavior is a recent Office of the Inspector General Case -

Novus Health Services and Optim Health Services, Inc.  This scam reaped $60 Million in a Medicare Fraud Scheme.  Sixteen people, which includes five physicians are named in the original indictment which you can view at:

https://www.justice.gov/file/942611/download

 

 Proof has been shown to the Prosecutors that employees were ordered to terminate patients lives, were ordered to kill people who were not even terminal.  People were placed in a Federally Funded Medicare Hospice Program who were not dying but ended up that way by overdoses of medications that should have never been used.  The only ones who benefited from this illegal activity were the owners and the employees who ended up with a cut of the profits; all paid by Medicare.  Not one single case has been prosecuted as murder. 

 

This is only the tip of the iceberg.  There are hundreds and hundreds of these government prosecuted cases.  Read the cases on this web site.  Read the scams used to coerce the public into trusting these wrongdoers.  People have been dying since time began and never before in America have patients been rounded up and basically executed for financial gain.  We can't think of a better way to explain what is going on.  It is unbelievable to all who have never seen it happen.  Unfortunately, it is true and the proof is on this site for your reading and numerous links to credible sources also exist here.  It is our hope that people will heed the lessons learned from these now public criminal behaviors and with hope and luck will be able to avoid experiencing them. 

 

Information found on this site may be freely distributed, published and shared with others.  Our only request is that credit due to original author and web site be made.

 

This is a Public Service Informational Web Site.

 

Comments and editorials not originally located from other readily identified sites are to be considered personal opinion of the authors.

 

The purpose of the web site hospicefraud.org is not to harm nor discredit any individual or corporation.  The material is not presented
with any form of malice. 


 

 

 

Anti-euthanasia orgs sound alarm on end-of-life bill

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Category: News Articles
Published: 28 February 2020
Anti-euthanasia orgs sound alarm on end-of-life bills
From:  https://www.lifesitenews.com/news/pro-lifers-divided-as-anti-euthanasia-orgs-sound-alarm-on-end-of-life-bill
 
Pro-lifers are divided about the language in the bill.
Thu Feb 27, 2020 - 4:58 pm EST
 
 
 By Calvin Freiburger
 
 

WASHINGTON, D.C., February 27, 2020 (LifeSiteNews) – Congress is currently considering legislation that would overhaul training and procedures for palliative and hospice care, but many have raised concerns that the bill would in practice hasten the deaths of seriously ill patients, including those whose situations are not terminal.

The Palliative Care and Hospice Education and Training Act, which passed the U.S. House of Representatives last October, requires the Department of Health & Human Services (HHS) to take steps to “provide support for Palliative Care and Hospice Education Centers” as they “improve the training of health professionals in palliative care,” according to its official summary. The bill also calls on the Agency for Healthcare Research and Quality to launch a “national education and awareness campaign to inform patients, families, and health professionals about the benefits of palliative care,” and on the National Institutes of Health to “expand national research programs in palliative care.”

The Euthanasia Prevention Coalition USA (EPCUSA) warns that in their estimation, the bill would have several far more troubling consquences, the first being the transfer of more non-dying patients to hospice care, a system “plagued by fraud, poor quality care leading to serious harm and deaths, while wasting hundreds of millions to billions of federal dollars

 

“Federal investigators found hospices enrolling patients who are not terminally ill, without their knowledge or under false pretenses, providing poor quality care, and inappropriately billing Medicare hundreds of millions of dollars,” the group notes. “Nearly half of hospices are unsure they could pass a government audit.”

These transfers would be exacerbated by language in the bill which EPCUSA says will allow “federal bureaucrats and palliative care insiders” to define what constitutes a “serious or life-threatening illness.”

“Palliative leads to the deaths of people who were not otherwise dying, typically by casually assessing people as terminal and placing them in hospice where they are heavily sedated, overdosed on pain killers and denied food and water so the diagnosis becomes self-fulfilling,” EPCUSA says. 

 

They acknowledge that bill’s Section 5 contains language that forbids spending funds on education about or promotion of assisted suicide, euthanasia, and so-called mercy killing, but predicts that additional language in the Senate version “will not stop the abuse and hastened deaths of people enrolled in hospice and palliative care.”

Discovery Institute senior fellow Wesley Smith, a prolific pro-life writer and bioethicist, disagrees. Last September, he wrote in National Review that he believes Section 5’s language is sufficient to keep the bill’s improvements to hospice care from morphing into cover for euthanasia.

“It should also be noted that the sponsors of the bill listened to the concerns that anti-euthanasia activists expressed about its previous iteration,” Smith wrote. “To be even more explicit and to prevent any confusion, this year’s version of the bill has added a clear statement that, in the programs it funds, ‘palliative care and hospice shall not be furnished for the purpose of causing, or the purpose of assisting in causing, a patient’s death, for any reason.’ There’s no wiggle room there.”

“As an anti-euthanasia activist for 26 years, I am not naïve,” Smith added. “I know that many assisted-suicide advocates wish to corrupt hospice and palliative care by authorizing killing in their names. But their perfidy is not a reason to oppose a bill with great potential to help so many people.”

“At first blush the new so-called ‘anti-euthanasia’ language looks good, but it does little or nothing. That's why there's no need for wiggle room,” attorney and EPCUSA board member Sara Buscher responded in a statement to LifeSiteNews. “The bill does not fund ‘the furnishing of palliative care and hospice.’ It funds education, research and public information programs.  The new language does not apply to the furnishing of medical care funded by Medicare, Medicaid and other federal programs because they are not funded by the bill.”

The U.S. Conference of Catholic Bishops (USCCB) and the Catholic Medical Association (CMA) have come out against against the House version of the bill but for the Senate version, arguing the latter’s language that “palliative care and hospice shall not be furnished for the purpose of causing, or the purpose of assisting in causing, a patient’s death, for any reason” would prevent it from being abused. The left-wing, Obama administration-colluding Catholic Health Association (CHA) supports both versions.

The National Association of Pro-Life Nurses has also come out against the bill, arguing that Section 5 is “toothless” because the practices it disavows “are already  considered acceptable by many influential hospice and palliative care doctors.”

“We believe that the Palliative Care and Hospice Education and Training Act (2019) will allow federal funding to teach and institutionalize such unethical practices without sufficient oversight, safeguards or penalties,” the group declared. “As nurses, we are also very concerned that the Act contains no conscience rights protection for those of us – doctors and nurses alike – who will do anything for our patients except deliberately end their lives or help them kill themselves.


 

 

 

 

 
 

"They've Killed Her"- Retired Alabama Schoolteacher Dies under State Guardianship

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Category: News Articles
Published: 31 August 2019
  • murder
  • euthanasia
  • School Teacher
  • Marian Leonard
“They’ve Killed Her” – Retired Alabama Schoolteacher Dies under State Guardianship

Mirrored here for Historical Purposes From  https://realnewsspark.com/2019/08/29/theyve-killed-her-retired-alabama-schoolteacher-dies-under-state-guardianship/?fbclid=IwAR0A7QzV84Ck4sSgKppibZ5dJ_riCH7aVgwrHNpyJ4dbfsGd6nP2UEdv7Qs

By Terri LaPoint
August 29, 2019

“She’s gone.” The call came in Monday from Nancy Scott regarding her mother, Marian Leonard, who had been taken from her family and placed onto hospice care against her will. Nancy was in tears when she told me that her mother died on Saturday, August 24, but nobody bothered to notify her until Monday.

Read more: "They've Killed Her"- Retired Alabama Schoolteacher Dies under State Guardianship

  1. 7 indicted, accused of neglecting, trafficking disabled and elderly adults in Georgia
  2. Sixteen Individuals Charged in $60 Million Medicare Fraud Scheme
  3. Activists from all over the U.S. Form a Committee of Concern to Expose the Mass-Murder of Elders in Skilled Nursing Facilities Justice for Covid-19 Eldercide
  4. How States Turned Nursing Homes Into Slaughterhouses By Forcing Them to Admit Discharged Covid-19 Patients

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