Health Care and Law

Double dipping: Medicare abuse and the hospice care system

November 12, 2014
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In recent years, hospice care has emerged as an option for families dealing with a seriously ill person who's nearing the end of life.

The concept is to try to make the patient as comfortable as possible and give that person time for final goodbyes with family and friends. Usually, such care lasts no more than a couple of months. On occasion, there are those who use the concept to rip off the system.

Earlier this summer, Pennsylvania hospice care provider Matthew Kolodesh, owner of Home Care Hospice Inc., was convicted and sentenced to nearly 15 years in prison for filing $16.2 million in false Medicare claims. The U.S. Department of Justice says the claims were for patients who either weren’t terminally ill or who stayed on hospice services for more than six months.

Most abuse cases that have been prosecuted by the feds involve for-profit providers. Most — if not all — hospice providers in West Michigan are nonprofits, such as Hospice of Grand Rapids and Faith Hospice at Trillium Woods. Under Medicare and Medicaid laws, hospice benefits are provided on a per-day basis to the hospice provider. It covers doctor services, medications for pain relief, homemaker services and even counseling for the family. However, there have been some fraud cases where the patient is receiving hospice care while at the same time undergoing therapeutic treatment, such as chemotherapy, where Medicare and Medicaid are also being billed. In other words, they’re double dipping.

While there have been occasions where people who are in hospice treatment make a dramatic turnaround, hospice is designed for those patients in the final months of life. If someone experiences such a recovery, they should be removed from the Medicare/Medicaid hospice program and transferred back to the traditional Medicare/Medicaid program.

If you suspect Medicare or Medicaid fraud in a hospice setting or any other health care situation, you should contact an experienced attorney who is used to dealing with such cases.

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