Hospice Fraud

Hospices provide important end-of-life palliative care and support services to patients and their families. Most hospice patients are covered by Medicare, which covers hospice for beneficiaries with six months or fewer to live. Medicare beneficiaries who elect to receive hospice care agree to forgo curative, life-prolonging treatment, deciding instead to receive comfort care.

Modern hospice care came to North America in 1971, and Medicare has covered this kind of end-of-life palliative care since 1983. Initially, most hospices in the United States were grass-roots, not-for-profit entities; now, however, large for-profit companies own a huge share of the hospice industry.

Unfortunately for hospice patients, their families, and tax payers, in some cases these companies put profits over the care and comfort of their patients. Indeed, since 2006, the U.S. government has pursued more than a dozen large hospice companies for committing fraud, accusing them of billing for services that they did not actually provide to their patients and admitting patients who were not terminally ill.

More than Money at Risk

Both kinds of fraud result in the hospice company making money for something it shouldn’t be paid for, but their implications for hospice beneficiaries are even more troubling. In some cases, the evidence shows that hospices are not providing the care that their terminally-ill patients need and deserve. In other cases, patients who are not actually terminally ill are signed up for hospice – that means that the patients and their families are told that they have 6 months or fewer to live, even when that isn’t the case, and that they have agreed to give up life-prolonging or curative treatment.

Hospice is undoubtedly an important and noble benefit, and most hospice providers give much needed comfort and support to patients at the end of their lives. When bad actors commit fraud, waste, or abuse, though, it is at the expense of some of the most vulnerable among us.