Corporate Compliance

Hospice group to pay U.S. $1.83 million in False Claims Act suit

Compliance Monitor, November 18, 2009

An Oregon hospice will pay the United States over $1.83 million to settle claims that it provided care without obtaining written certifications of the terminally ill, according to a Department of Justice (DOJ) press release.
Kaiser NW, a collective of Kaiser Foundation Hospitals, disclosed to the OIG that between 2000 and 2004, Kaiser NW billed Medicare for its hospice beneficiaries prior to obtaining written certifications for care provided during the initial certification period. According to the DOJ, Medicare hospice care providers must obtain written certification of terminal illness for each hospice beneficiary’s first 90 days of care from the hospice’s medical director and the patient’s attending physician.
The certifications are necessary for Medicare to decide whether hospice care is medically necessary.

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