A former hospice owner has pleaded guilty to one count of conspiracy to commit health care fraud in a Greenville, Mississippi court.
Charline Brandon of Cleveland, Mississippi, submitted nearly $11 million in fraudulent claims to Medicare and more than $2 million to Medicaid while running Cleveland-based Haven Hospice, North Haven Hospice, Lion Hospice and North Lion Hospice, according to a press release.
“Hospice is designed for end-of-life care, to care for our most vulnerable people, not for personal gain,” Mississippi Attorney General Jim Hood said in a statement. “Unfortunately, this defendant was billing the taxpayers for patients who were not terminal. It is our duty to make sure our tax dollars are not stollen so there is money available to care for those who are terminally ill. ”
Brandon admitted during a change of plea hearing that she also illegally recruited patients who were not eligible for hospice care. She faces up to 10 years in prison and $250,000 in fines, according to the Associated Press. The government also wants Brandon to forfeit illegal gains and make restitutions.
“This is one of the largest and most egregious hospice schemes I have seen in Mississippi,” Derrick L. Jackson, special agent in charge at the U.S. Department of Health and Human Services, Office of Inspector General (OIG) in Atlanta, said in a statement.
Home Health Care News previously discussed the state of hospice fraud in the United States with Jackson during an August interview. OIG agents have told HHCN that Mississippi is particularly notorious for hospice fraud schemes characterized by predatory marketing and other illicit behavior.
The U.S. Department of Health and Human Services has led a multi-year state-federal investigation into fraud in Mississippi called Hospice Storm. At least eight people have been convicted since 2014, the Associated Press reported.
“Joint investigations such as this one are key to protecting our health care system,” Hood said.
U.S. District Judge Debra Brown has set sentencing for Jan. 29.
This case was investigated by the Department of Health and Human Services, OIG and the Mississippi Attorney General’s Office.
OIG, in addition to other regulators, has reported plans to vehemently go after dishonest hospice providers over the last few months.
Billing fraud throughout the hospice industry is collectively costing the government hundreds of millions of dollars each year, HHCN previously reported.
As the key federal watchdog tasked with investigating misconduct related to Medicare and Medicaid, OIG highlighted several cases of fraud and abuse in a report released in July.
Legislation to further combat Medicaid fraud was introduced in the House on Sept. 28.
Democratic Rep. Peter Welch of Vermont unveiled the bipartisan legislation to combat fraud and abuse originating outside of institutional health care settings. The bill would build on the authority of state Medicaid Fraud Control Units and expand the scope to encompass all Medicaid services including non-institutional settings, such as home health care.
Written by Kaitlyn Mattson