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Hospice coughs up $3 million for integrity agreement settlement.<\/strong><\/em><\/span><\/p>\n A whistleblower lawsuit filed by hospice physicians has cost one nonprofit Florida hospice $2.5 million \u2014 and it could have been much worse.<\/p>\n Health and Palliative Services of the Treasure Coast Inc.<\/strong>,\u00a0The Hospice of Martin and St. Lucie Inc.<\/strong>, and\u00a0Hospice of the Treasure Coast Inc.\u00a0<\/strong>have paid $2.5 million to settle the case, the\u00a0Department of Justice\u00a0<\/strong>says in a release. The hospice billed Medicare for ineligible patients, the DOJ says.<\/p>\n Physicians\u00a0John Simons\u00a0<\/strong>and\u00a0Lewis Cook\u00a0<\/strong>received more than $476,000 from the announced recovery, according to the DOJ.<\/p>\n In a statement furnished to local news outlet\u00a0TCPalm.com<\/em>, Treasure Coast said \u201cthe actual care that was provided to patients was never in question; this has been a dispute over documentation,\u201d the website reports.<\/p>\n However, relator Cook told\u00a0TCPalm.com\u00a0<\/em>that top executives ordered doctors to \u201cfind a way\u201d to keep Medicare beneficiaries in hospice for as long as possible. The whistleblower complaint alleged employees were trained to falsify documentation to make stable but chronically ill patients appear terminally ill and to underestimate patients\u2019 life expectancies, the website reports.<\/p>\n Also:\u00a0<\/strong>The hospice\u2019s then-CEO allegedly told the doctors to \u201cshut up\u201d and \u201cjust sign the order\u201d for inpatient admissions, among other shady practices, according to court records.<\/p>\n The hospice\u2019s settlement amount was relatively low because a larger one would have put the provider out of business, the whistleblowers\u2019 attorney told\u00a0TCPalm.com<\/em>.<\/p>\n Hospice Provider Inks Record-Breaking Integrity Agreement Penalty<\/strong><\/span><\/p>\n If you need a reminder of why you should walk the line and avoid having to enter into Integrity Agreements with the\u00a0HHS Office of Inspector General<\/strong>, check out a new\u00a0Government Accountability Office\u00a0<\/strong>report about the agreements.<\/p>\n IAs and Corporate Integrity Agreements contain \u201cstipulated penalties\u201d with penalty amounts that are \u201cnon-negotiable\u201d and do not change across agreements. They range from $1,000 to $50,000 per violation, the GAO report says.<\/p>\n An unnamed hospice provider paid a record-setting $3 million due to such a penalty. It \u201cresulted from the entity\u2019s failure to correct improper billing processes and poor claims submission practices that had led to error rates and overpayments … by Medicare for hospice services,\u201d the GAO says. \u201cThese issues were uncovered through the claims reviews required under the agreement and HHS-OIG\u2019s site visits.\u201d<\/p>\n See the report at\u00a0www.gao.gov\/assets\/700\/691034.pdf<\/a>.<\/p>\n Source- SuperCoder<\/span><\/i><\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Hospice coughs up $3 million for integrity agreement settlement. A whistleblower lawsuit filed by hospice physicians has cost one nonprofit Florida hospice $2.5 million \u2014 and it could have been … Continue Reading →<\/a><\/p>\n","protected":false},"author":1,"featured_media":398,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20],"tags":[11,12,14],"class_list":["post-397","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fraud-aduse","tag-home-care","tag-hospice","tag-snf"],"_links":{"self":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/397","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/comments?post=397"}],"version-history":[{"count":1,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/397\/revisions"}],"predecessor-version":[{"id":399,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/397\/revisions\/399"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/media\/398"}],"wp:attachment":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/media?parent=397"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/categories?post=397"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/tags?post=397"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}