Former Compliance Director Represented by Bracker & Marcus LLC
Bracker & Marcus LLC is pleased to announce the intervention and settlement of claims of False Claims Act violations raised against a hospice care provider and two of its senior executives. STG Healthcare of Atlanta, Inc. will pay $1.75 million to settle allegations that STG, operating as Interim Healthcare of Atlanta, admitted and billed Medicare and Medicaid for non-terminal patients.
Hospice care focuses on the quality of life for patients who are experiencing an advanced, life-limiting illness, by providing compassionate care for those in the last phases of incurable disease so that their final days are lived as comfortably as possible. Medicare and Medicaid provide hospice care benefits to patients determined by a physician to be “terminally ill,” defined as having six months or less to live.
The settlement covers allegations that most of the patients at the Interim facility were not terminally ill, yet were being certified and recertified for years without showing signs of declining health. STG was also alleged to have paid a physician who referred and admitted patients for hospice care as a ‘back up” medical director, but who did not legitimately serve as a hospice physician.
This scheme generally arises when hospice management, rather than medical providers, make the ultimate determinations as to who should be admitted to hospice care, often with a focus on keeping their census up and their reimbursements high. They frequently set aggressive goals that require nursing staff to admit patients that do not qualify and do not need hospice services. Objections by compliance officers and nurses are disregarded by management because discharging patients hurts their bottom line.
“Hospice is not a blank check for unscrupulous medical providers willing to admit patients who are not terminally ill,” said U.S. Attorney Byung J. “BJay” Pak. “It is reserved for those who truly need it. We will also continue to prioritize cases where it appears that a medical decision, especially the decision to forego curative treatment, has been influenced by a kickback.”
The attorneys at Bracker & Marcus LLC have experience representing whistleblowers in hospice care fraud cases, having previously filed a similar action resulting in a $3 million settlement with Guardian Hospice of Georgia. If you are aware of a hospice that is admitting patients who are not terminally ill, please call us today.