If you know of a hospice company that is defrauding the Medicare system, contact experienced health care fraud attorney Kay Van Wey today.

Texas attorney discusses health care fraud

From 2005 to 2009, Medicare spending on hospice rose a staggering 70 percent to more than $4.3 billion. Hospice care, also known as end of life care, has become more popular for patients who are in their final days and wish to live more comfortably, but some say for-profit hospice companies are taking advantage of the government.

Why Has Government Spending on Hospice Care Increased?
Medicare covers hospice care for people with terminal illnesses who are expected to live less than six months, as long as they are receiving care at an approved facility. Nearly 58 percent of the increased costs are due to more patients being enrolled in hospice programs. In 2009 alone, more than 1 million people received hospice care.

While the number of patients receiving hospice care has increased, so has the number of for-profit companies providing that care. In 2009, more than half of all hospices were for-profit, with most of their money coming from Medicare rather than non-profit and government-owned hospices.

Currently, Medicare pays $143 daily for routine home hospice care. For-profit hospice care companies are capitalizing on this, collecting 29 percent more per beneficiary than non-profit hospices. Critics say that the current payments by Medicare incentivize overuse and encourage these for-profit companies to find patients who will stay longer.

In a study published in the Journal of the American Medical Association, researchers found that for-profit hospices had more patients who had fewer medical needs and longer lengths of stay, which meant more money for those companies, paid largely by Medicare. Currently, Medicare pays for 84 percent of all hospice patients.

Health Care Fraud Suspected
Both federal and state governments, both tight for money, are now launching investigations into some of the largest for-profit hospice companies to determine whether they have been defrauding Medicare. This past June, Gentiva, the country's fastest growing for-profit hospice care company, agreed to pay $12.5 million to settle a claim that the company had billed Medicare for services it did not provide.

Right now, Vitas, the country's largest for-profit hospice company is the subject of fraud investigations by both the Department of Justice and Texas' Attorney General Greg Abbott.

Critics of the for-profit hospice companies say that Medicare is paying more because these for-profit companies choose patients to treat who they know will live the longest and require less care, thereby maximizing the payment the company receives from Medicare. For example, rather than choosing to treat cancer patients who likely have less time to live, these for-profit hospice companies are choosing to treat Alzheimer's and dementia patients, giving hospice companies an average earning of $21,306 per nursing home patient, which is over $3,000 more than the overall average cost per hospice patient.

Moreover, the services being provided by these for-profit hospice companies are similar to services already being paid for at nursing home facilities. Medpac, the government's Medicare Payment Advisory Commission has recommended that Medicare increase payments for services at the beginning and end of the care cycle. Further, it recommended that Medicare investigate relationships between the hospice companies and long-term care facilities.

Hold For-Profit Hospice Companies Accountable
If you know a for-profit hospice company that is defrauding Medicare, you should blow the whistle on these deceptive practices. An experienced health care fraud attorney at Van Wey Law can help you determine the right course to take. Call us today at (214)329-1350 or (800)489-5082.

Don't hesitate to contact Kay Van Wey at (800)489-5082 for a free, no obligation consultation.

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