HPH Hospice To Pay $1 Million To Resolve False Claims Act Allegations

TAMPA – The United States Attorney’s Office for the Middle District of Florida announced today that Hernando-Pasco Hospice, Inc., d/b/a HPH Hospice, has agreed to pay $1 million to resolve allegations that it violated the False Claims Act by submitting false claims for hospice services to the Medicare and Medicaid programs. HPH Hospice is a Florida not-for-profit corporation that provides hospice services in various locations throughout Hernando, Pasco, and Citrus counties in Florida.

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Translation The Medicare hospice benefit is available for patients who have a life expectancy of six months or less if their disease runs its normal course. Patients admitted to a hospice stop receiving care to cure their illnesses and instead receive medical care focussed on providing them with relief from the symptoms, pain, and stress of a terminal illness. Medicare reimburses for different levels of hospice care.

Today’s settlement resolves allegations that between January 1, 2005, and December 31, 2010, HPH Hospice submitted false Medicare and Medicaid claims for patients who did not need end of life care. The government alleged that HPH Hospice caused staff to admit ineligible patients in order to meet targets imposed by management, adopted procedures to delay and discourage staff from discharging patients who were not appropriate for hospice services, instructed staff to make false or misleading statements in patients’ medical records to make them appear eligible when they were not, and failed to implement an adequate compliance program that might have corrected these problems.

The settlement also resolves allegations that HPH Hospice billed the government at higher reimbursement rates than it was entitled to receive, and provided illegal kickbacks when it provided free services to skilled nursing facilities in exchange for patient referrals.

“The hospice industry provides medical care to our most vulnerable citizens. This settlement should send a message to providers that misconduct of this kind will not be tolerated,” stated A. Lee Bentley, III, Acting United States Attorney for the Middle District of Florida.

As part of the settlement, HPH Hospice has agreed to enter into a Corporate Integrity Agreement with the Inspector General of the Department of Health and Human Services that provides for procedures and reviews to be put in place to avoid and promptly detect conduct similar to that which gave rise to the settlement.

The allegations settled today arose from a lawsuit filed by two former HPH Hospice employees, Heather Numbers and Greg Davis, under the qui tam or whistleblower provisions of the False Claims Act. Under the Act, private citizens can bring suit on behalf of the United States for false claims and share in any recovery. The whistleblowers in this case will collectively receive $250,000.

This matter was handled by the Justice Department’s Civil Division, the U.S. Attorney’s Office for the Middle District of Florida, the Office of the Inspector General for the Department of Health and Human Services, and the Florida Attorney General’s Office, Medicaid Fraud Control Unit.

The lawsuit is captioned United States and State of Florida ex rel. Numbers and Davis v. Hernando-Pasco Hospice, Inc., et al., No. 10-cv-912 (M.D. Fla.). The claims settled by this agreement are allegations only; there has been no determination of liability.