On July 17, 2024, the Department of Justice announced that Kindred at Home, a hospice company, agreed to pay $19.428 million to resolve False Claims Act allegations that Kindred “knowingly submitted false claims and knowingly retained overpayments for hospice services provided to patients who were ineligible to receive hospice benefits under various federal health care programs.”
For a patient to be eligible to elect Medicare hospice benefits, and for a hospice provider to be entitled to bill for such benefits, the patient must be certified as “terminally ill,” meaning the patient has a medical prognosis of a life expectancy of six months or less.
The settlement resolved allegations in several qui tam actions, including one that Gregg Shapiro filed in Rhode Island on behalf of his whistleblower client, a former employee of Kindred’s hospice operation in Warwick, Rhode Island. The whistleblower alleged that, in or about June 2017, Kindred completed an internal audit which determined that approximately 150 of Kindred’s hospice patients in Rhode Island were not terminally ill and thus were not eligible for the Medicare hospice benefit. Many of these approximately 150 patients had been on hospice for several years. As a result of the audit, Kindred planned to discharge these approximately 150 patients, but, in order to limit negative impact on customer referral relationships with the nursing homes where many of these patients lived, Kindred allegedly decided to discharge only about 25 of the patients each month.
The whistleblower alleged that Kindred did not repay Medicare the money it received for providing hospice care to these approximately 150 patients either prior to or after June 2017, even though it knew from the audit findings that the patients were ineligible for hospice care before June 2017.
The whistleblower team appreciates the excellent work of DOJ Trial Attorney Will Olson and Assistant United States Attorney Kevin Hubbard, of the District of Rhode Island, in achieving this settlement.