Hospice care provider Caris Healthcare has agreed to pay $8.5 million to resolve a whistle blower lawsuit accusing it of submitting false Medicare claims and retaining over-payments for patients who were ineligible for the Medicare hospice benefit because they were not terminally ill.
The company has reached a settlement with the US Department of Justice and the United States Attorney for the Eastern District of Tennessee, according to a statement.
Caris Healthcare provides hospice services to Medicare and Medicaid beneficiaries in Tennessee, Virginia, and South Carolina.
The lawsuit alleged that Caris was admitting and recertifying patients for hospice when they did not meet the appropriate admissions or recertification criteria. It specifically said that Caris directed patients be admitted into hospice even when the nurse performing the admissions assessment recommended the patient not be admitted.
The complaint further alleged that Caris also instructed its nurses to "chart negatively," or only document things that showed the patient was declining. The company also directed nurses to change their assessment notes and, at times, deleted information that showed the patient was stable or improving.
The United States filed its Complaint in Intervention on October 11, 2016. Pursuant to the False Claims Act provisions, the Relator will be awarded $1,402,500 from the Government's recovery.
Hospice care, Healthcare, Lawsuit, Medicare, Medicaid, Caris Healthcare, US