Company accused of ripping off Medicare hospice benefits
Jordan Rau
WASHINGTON — A national hospice company improperly cycled patients through nursing homes and hospices with a goal of making as much profit as possible from Medicare, according to a whistleblower lawsuit announced this week.
Federal attorneys also sued the company, AseraCare, alleging that it milked Medicare's hospice benefit by pressuring its employees to admit people into hospices who weren't dying and that it resisted discharging them despite evidence that they weren't deteriorating. One hospice patient who should have been immobile from end-stage heart disease was healthy enough to go to his granddaughter's graduation and on a berry-picking excursion with a friend, the government charges.
For years, some critics of Medicare's hospice benefit have said that the way the government pays providers gives them incentives to abuse the system. The suits against AseraCare, a Fort Smith, Ark.-based company that operates in 19 states, follow several other suits against big hospice companies, but they go further in alleging that the company coordinated its use of nursing care and hospice care to maximize Medicare reimbursements.
The company is owned by Golden Living, a national company that also provides skilled nursing and other services. The whistleblowers contend that AseraCare first recruited patients who were eligible for skilled nursing care for 20 days, for which Medicare pays the entire bill. After 20 days, when Medicare requires patients to pick up part of the tab, AseraCare had the nursing homes send the patients to hospices, according to the lawsuit.
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