Health and Palliative Services of the Treasure Coast, Inc., The Hospice of Martin and St. Lucie, Inc., and Hospice of the Treasure Coast, Inc. Paid $2.5 Million to Settle False Claims Allegations
Health and Palliative Services of the Treasure Coast, Inc., The Hospice of Martin and St. Lucie, Inc., and Hospice of the Treasure Coast, Inc. have paid $2.5 million to settle allegations that they violated the False Claims Act by submitting false claims to Medicare for hospice patients.
“When individuals file false claims, they defraud Medicare’s hospice benefit program and divert taxpayer monies away from vital services,” stated U.S. Attorney for the Southern District of Florida Benjamin G. Greenberg. “The U.S. Attorney’s Office will continue to aggressively pursue all health care providers who violate statutory and regulatory provisions that are designed to protect the citizens who depend upon the legitimate care provided by government-sponsored healthcare programs.”
“Those who would exploit Medicare’s hospice benefit to boost their profits in lieu of patient care expropriate precious tax dollars intended for terminal patients in a time of great need,” said Special Agent in Charge Shimon R. Richmond of the U.S. Health and Human Services, Office of the Inspector General (HHS-OIG). “Our Special Agents will relentlessly pursue health care professionals who threaten the integrity of Federal health care programs."
According to the record, Health and Palliative Services of the Treasure Coast, Inc., The Hospice of Martin and St. Lucie, Inc., and Hospice of the Treasure Coast, Inc. (“the defendants”) are providers of hospice services, in that they, among other things, operate and maintain hospice care facilities and provide home hospice care and hospice services in assisted living facilities and skilled nursing homes throughout the "Treasure Coast” of Florida (an area located on the state's Atlantic coast, comprised of Indian River, St. Lucie, and Martin Counties). The settlement, recently made public, resolved allegations that between 2005 and 2011, the defendants knowingly submitted or caused to be submitted false claims to Medicare, for services to hospice patients who were not eligible for all or part of their hospice care under Medicare requirements. Medicare’s hospice benefit is available for patients who elect palliative treatment (medical care focused on the patient’s relief from pain and stress) for a terminal illness and have a life expectancy of six months or less if their disease runs its normal course. Patients who elect the hospice benefit forgo the right to curative care (medical care focused on treating the patient’s illness).
The allegations settled in this case arose from a lawsuit filed by whistleblowers, John Simons, M.D. and Lewis Cook, M.D., under the qui tam provisions of the False Claims Act. Under the False Claims Act, private citizens can bring suit on behalf of the government for false claims and share in any recovery. The whistle blowers in this matter were medical doctors formerly employed by the defendants. The doctors alleged that the defendants’ hospice centers were submitting false claims to the United States in relation to hospice care for Medicare patients. The whistle blowers’ complaint alleged that the defendants billed for patients who were not terminally ill and thus did not qualify for the hospice benefit. The doctors received $476,373.73 from the announced recovery.
This case is captioned United States ex rel. John Simons and Lewis Cook v. Health and Palliative Services of the Treasure Coast, Inc., 11-14328-Martinez (S.D. Fla.). This matter was handled by Southern District of Florida Assistant U.S. Attorney Mark Lavine and HHS-OIG.