Hospice Company Agrees to $12 Million to Settle Medicare Fraud Case

Hospice of Arizona, L.C., its related entity American Hospice Management LLC, and their parent corporation American Hospice Management Holdings LLC have agreed to pay $12 million to settle allegations they violated the False Claims Act by submitting false reimbursement claims to Medicare for ineligible hospice services, the Department of Justice announced on Wednesday. 

Between Sept. 1, 2002 and Dec. 31, 2010, Hospice of Arizona allegedly submitted or caused the submission of false Medicare claims for patients who didn’t need end-of-life care, or for whom the hospice billed at a higher reimbursement rate than it was entitled. 

Hospice of Arizona and its related entities would pressure staff to find patients eligible for Medicare and use procedures that would either delay or discourage staff from discharging patients from hospice when they were no longer appropriate for such services in an effort to get higher Medicare reimbursements, according to the government. 

“The hospice industry relies on the Medicare Trust Fund, and payments for unnecessary services jeopardize its financial viability,” said U.S. Attorney for the District of Maryland Rod J. Rosenstein.

As part of the settlement, American Hospice Management Holdings has also agreed to enter into a corporate integrity agreement with the Inspector General of the Department of Health and Human Services that provides for procedures and reviews to be put in place to avoid and promptly detect similar behavior to that which initiated the allegations in the first place and the resulting settlement. 

Written by Alyssa Gerace

Alyssa Gerace