Is Your Hospice or Home Healthcare Employer Submitting False Documents to Medicaid or Medicare?
Our Attorneys Help Nurses, Physicians, Technicians and other Health Care Professionals Report Fraud and Claim a Cash Whistleblower Reward
Hospice is a health care system designed to ensure terminally ill patients are able to live in comfort and with dignity. In 1983, hospice became a Medicare benefit for patients whose doctors diagnosed with less than six months to live.
Home healthcare offers another form of care that provides comfort and convenience for patients who are homebound and require regular medical treatment, therapy or monitoring. Both hospice and home healthcare services are covered by Medicare and Medicaid for eligible patients.
Despite government efforts to combat fraud among hospice and home healthcare agencies, corrupt hospice facilities and home healthcare providers continue to abuse Medicare and Medicaid funds for profit, jeopardizing the valuable benefits of these programs. Millions of dollars lost to fraudulent practices and false claims by hospice and home healthcare facilities continue to go undetected.
Physicians, nurses, technicians and other healthcare professionals who have inside knowledge of misconduct are crucial in putting a stop to the fraud, waste and abuse of taxpayer dollars. Under the federal False Claims Act, 31 U.S.C. §§ 3729 – 3733, individuals who report hospice or home healthcare fraud may be eligible for a substantial cash whistleblower award.
If you suspect your hospice or home healthcare employer is submitting false claims to Medicare, Medicaid or other government healthcare program, you could receive a large cash reward for reporting your information. Renowned U.S. whistleblower lawyer Brian Mahany and the MahanyLaw team work to maximize whistleblower cash awards in federal and state courts across the country. To learn whether your information could lead to a cash whistleblower award, connect with the MahanyLaw team for a free, confidential consultation: 202.800.9791 or Report Online
Examples of Hospice Fraud False Claims Act and Anti-Kickback Statute Violations
The Office of the Inspector General Hospice Compliance Program Guidelines list several noncompliance risk areas for hospice care. The most common types of hospice fraud that violate the False Claims Act and Anti-Kickback Statute include:
- Promoting hospice services to benefit ineligible patients
- Offering cash, discount or gift incentives for patient referrals
- Double billing arrangements between a hospice and other health care providers
- Failure to obtain physician-verified prognosis of terminal illness
- Failure to obtain physician-certified plan of care
- Falsifying certifications, medical records or care plans
- Obtaining uninformed consent from beneficiaries
- Providing incomplete or substandard care
- Billing for medically unnecessary treatments, equipment or services
- Billing for higher level of care than provided
- Billing for services not provided
- Billing for more expensive services than actually rendered
- Insufficient oversight of patients receiving over six consecutive months of care
- Filing claims for ineligible beneficiaries
- Providing care without required certification
- False documentation
If you feel your health care employer is participating in hospice or home healthcare fraud, contact Brian Mahany, representative for the largest whistleblower settlement in history that resulted in a $170 million cash whistleblower award.
The MahanyLaw team focuses on protecting whistleblower privacy, client rights and maximized awards. To confidentially discuss your options and eligibility for a cash award, call 202.800.9791 or Report Online
Common Home Healthcare Fraud Violations and Warning Signs
Like hospice fraud, home healthcare fraud continues to plague our nation’s government-funded health care programs. The Center for Medicare and Medicaid Services estimates that Medicare paid over $10 billion in improper payments to home healthcare agencies in fiscal year 2015. The federal government is cracking down on Medicare and Medicaid fraud among home healthcare agencies.
The same types of fraud typically seen in hospice care (listed above) are also found among home healthcare agencies. The three most common types of fraud occurring in home healthcare services include:
- Offering cash payment, discounts or gifts for patient referrals
- Billing for medically unnecessary services
- Falsely claiming that patients are homebound or that care is medically necessary
- Payment arrangements for services that are not commercially reasonable or of fair market value
The Office of the Inspector General lists five warning signs that may indicate home healthcare fraud:
- Beneficiary medical records show no recent appointments with supervising doctor
- Care does not follow a recent nursing home or hospital stay
- Patient medical records show a principal diagnosis of hypertension or diabetes
- Beneficiary claims arising out of multiple agencies
- Beneficiary records show multiple home care readmissions in close association
Whistleblower cash awards often range in the hundreds of thousands to millions of dollars for hospice and home healthcare professionals who report fraud against the government.
Our MahanyLaw whistleblower lawyers recently secured a $40 million whistleblower cash award and will help you win your case in the fight against fraud.
If you have inside information on false documentation and want to claim a cash whistleblower reward, call Brian Mahany and the MahanyLaw whistleblower fraud recovery team for a private, no-fee consultation: 202.800.9791 or Report Online
You May be Entitled to a Cash Award for Reporting Hospice or Home Healthcare Fraud
State and Federal False Claims Acts contain whistleblower provisions that offer large cash awards to individuals whose original source information on hospice or home healthcare fraud leads to successful government recovery. Whistleblower awards may be:
- 10% to 25% of total government recovery amount when the government choses to intervene in the lawsuit.
- 25% to 30% of total government recovery amount when the government declines to intervene in the lawsuit.
Whistleblowers may also receive reasonable attorneys’ fees and costs of litigation in cases leading to successful verdict or settlement.
How to Report Hospice or Home Healthcare Fraud and Receive a Cash Award
In order to win a whistleblower lawsuit and collect your cash award, you must possess non-public, original information of financial harm to the federal or state government. In addition, you must be the first to report the fraud to be eligible for a whistleblower award and must file your claim within the time frame outlined in federal and state statutes of limitations.
The whistleblower claims process is complex and must be flawless from start to finish. Your first step is to contact the MahanyLaw team. Our experienced attorneys will confidentially evaluate the facts of your case and inform you of your options.
If you choose to proceed, Brian Mahany and the MahanyLaw Team will assist you in proper evidence collection and filing a claim that will maximize your cash award.
The MahanyLaw team helped to recover over $10 billion for U.S. taxpayers in 2014 and 2015 and continues to advocate for whistleblowers nationwide. If you suspect your hospice or home healthcare employer of defrauding Medicaid or Medicare, do not hesitate to contact our MahanyLaw whistleblower team for a no-obligation, confidential consultation. Our experienced attorneys will protect your privacy, evaluate your concerns and help you move forward with your claim: 202.800.9791 or Report Online