September 17, 2014 — The federal False Claims Act empowers health care insiders to file a whistleblower lawsuit on behalf of the United States. The government relies on tipsters to protect the integrity of our federal healthcare programs for those who need them. When medical providers bilk the system by overbilling Medicare for hospice care services that are unnecessary, they put the continued viability of hospice benefits at risk. Whistleblowers, who are also referred to as “relators,” are entitled to a portion of the government’s recovery. Under the Act, the United States has the ability to intervene in the lawsuit and assume primary control for litigating it. The statute provides for a recovery equivalent to three times the actual damages plus civil penalties.
Evercare Hospice And Palliative Care In Colorado Allegedly Filed Intentional False Claims With Medicare For Hospice Care To Patients Who Were Not Terminally Ill
In two consolidated whistleblower lawsuits filed in Colorado against Evercare Hospice and Palliative Care, the United States has decided to intervene on part of the claims. The lawsuits allege False Claims Act violations by Evercare, a nationwide hospice provider, which is now Optum Palliative Care and Hospice Care.
Medicare pays hospice benefits for patients who are terminally ill and expected to live no more than six months. Hospice focuses on palliative care, which includes treatment for pain relief and stress associated with illness. A Medicare beneficiary may receive benefits for treatment to cure an illness or for palliative care, but not both. When hospice care begins, benefits for curative medical treatment end.
In the qui tam lawsuits filed against Evercare, the provider’s former employees alleged that Evercare intentionally filed false claims with Medicare for hospice services provided for patients who were not terminally ill. The tipsters alleged that Evercare management drove doctors and staff to admit patients without terminal illnesses. When physicians directed that patients should be discharged, management reportedly challenged or disregarded the orders.
False Claims Act Lawsuits Target Abuse By Medical Providers
While Waters & Kraus is not handling this particular False Claims Act case, we are representing whistleblowers in similar lawsuits. If you have comparable claims against a different medical provider, contact us by email or call our qui tam attorneys at 855.784.0268 to learn more about our practice and how we can work together to notify the government about fraudulent abuses of government-funded programs. George Tankard and Anne Izzo, qui tam lawyers in Waters & Kraus’ Maryland office, protect tipsters throughout the whistleblower lawsuit process.