Preliminary Injunction Entered in Justice Department Suit to Stop Fraudulent Debt Collection Scheme that Harmed Veterans
TULSA, Okla. – United States Attorney Clinton J. Johnson announces that Evergreen Hospice, LLC (Evergreen), a hospice company located in Tulsa, Oklahoma, has agreed to pay $48,830.70 to resolve allegations that it violated the False Claims Act by knowingly submitting false claims to Medicare for hospice care provided to beneficiaries who did not qualify for the services. The claims resolved by the settlement are allegations only; there has been no determination of liability.
“Unfortunately, some healthcare providers seek to defraud Medicare by billing unnecessary hospice services,” stated U.S. Attorney Clinton Johnson. “Left unchecked, this misconduct would deplete funds available for terminally ill patients desperately in need of the relief that hospice care provides. This settlement should serve as notice to others who consider similar practices that we will vigorously pursue them.”
Hospice care is special end-of-life care for terminally ill patients intended to comfort the dying. Patients admitted to hospice care generally stop receiving coverage for traditional medical care intended to cure their illnesses and instead receive medical care focused on providing them with relief from the symptoms, pain, and stress of a terminal illness. Medicare patients are hospice eligible when they are considered terminally ill and have a life expectancy of six months or less, if their illness runs its normal course.
This settlement resolves allegations that Evergreen knowingly submitted false claims to Medicare for hospice services provided to patients who were not terminally ill and for services that were not medically necessary. According to the settlement agreement, the United States alleged that Evergreen knowingly submitted false claims from Sept. 1, 2017, to May 31, 2020, to Medicare for hospice services that were provided to beneficiaries who did not qualify under the Medicare guidelines for routine hospice care because they were improperly certified as terminally ill.
The government’s action in this matter illustrates the emphasis on combating health care fraud, and one of the most powerful tools in this effort is the False Claims Act. Tips from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 800-HHS-TIPS (800-447-8477).
Assistant U.S. Attorney Marianne Hardcastle prosecuted this case.
The Office of Inspector General for the U.S. Department of Health & Human investigated this case.