WASHINGTON – Odyssey HealthCare, a national hospice provider, has paid the United States $12.9 million to settle allegations that the company submitted false claims to Medicare, the Justice Department announced today. The Dallas-based company is alleged to have billed Medicare for services provided to hospice patients who were not terminally ill and therefore were ineligible for the Medicare hospice benefit.
The settlement, which covers a period from 2001 to 2005, also resolves charges originally brought against Odyssey HealthCare by a former regional vice president, JoAnne Russell. As part of the settlement, Ms. Russell will receive $2,326,500 for bringing the matter to the attention of the government. Under the qui tam or whistleblower provisions of the False Claims Act, a private party can file an action on behalf of the United States and receive a portion of the settlement if the government takes over the case and prosecutes it successfully.
“The fiscal integrity of the Medicare hospice benefit program depends upon compliance with eligibility standards ,” said Peter D. Keisler, Assistant Attorney General for the Justice Department’s Civil Division. “The United States will take action against providers that fail to comply with those standards.”
Odyssey HealthCare has also entered into a Corporate Integrity Agreement with the Office of Inspector General of the Department of Health and Human Services. The Corporate Integrity Agreement addresses the company's practices regarding compliance with applicable Medicare regulations.
This settlement was the result of a collaborative investigation involving the Department of Justice’s Civil Division, the U.S. Attorney’s Office for the Eastern District of Wisconsin, the U.S. Attorney’s Office for the Southern District of Texas, and the Department of Health and Human Services’ Office of the Inspector General.