On May 18, 2018, the Department of Justice announced a settlement with a hospice facility for $2.5 million regarding what was characterized as “documentation errors” by the facility. Health and Palliative Services of the Treasure Coast, Inc., Hospice of Martin and St. Lucie, Inc. and Hospice of the Treasure Coast, Inc. – all Florida nonprofit hospice providers (now known as Treasure Coast Hospice) – agreed to settle the allegations of a False Claims Act lawsuit filed in 2011. The settlement can be found here and the corporate integrity agreement here.

Two doctors who formerly worked at the hospice claimed the management team “encouraged staff to fake medical records and enroll patients in hospice care even if they lacked the terminal illness diagnosis that Medicare’s hospice benefit requires.”  According to the relators, this runs afoul of Medicare’s hospice benefits, which are available to patients “with a terminal illness and a life expectancy of six months or less, based on a doctor’s certification.” The government joined the doctors’ suit in an amended complaint in August 2017.

The doctors “claimed a pervasive strategy of boosting profits by claiming Medicare hospice benefits for patients who weren’t eligible.” The government claims that Treasure Coast Hospice billed Medicare for 69 patients between 2005 and 2011 “who were ineligible for some or all of their Medicare hospice benefits, according to the settlement agreement.”

Treasure Coast Hospice is also subject to a five-year corporate integrity agreement from November 2017, which requires it “follow a compliance program, file annual reports to the HHS, and follow other steps meant to prevent improper billing.”