A recent Medicare whistleblower lawsuit being pursued by the U.S. Department of Justice asserts that Vitas Hospice and Vitas Healthcare, the largest chain providers of hospice services in the United States, improperly billed Medicare for medically unnecessary services, services that were never performed and for services provided to patients not eligible for Medicare coverage. Vitas was started by Florida’s Senate President, Don Gaetz in the 1980s.
The Medicare False Claims Act lawsuit alleges that Vitas defrauded the government out of millions of taxpayer-funded Medicare dollars over a span of 12 years. Gaetz is not included in the whistleblower lawsuit and denies any involvement in the alleged fraudulent Medicare reimbursement claims.
According to the complaint filed by the DOJ, Vitas created a quota system for its employees for the number of crisis-care days that had to be logged for Medicare reimbursement. Crisis-care reimbursement is the high-dollar claim for a hospice unit, often several hundred dollars more than general hospice care. The crisis rate is the highest payout rate for Medicare reimbursement of hospice claims.
Vitas was sold to Chemed in 2004.
Medicare covers hospice care for those who are expected to succumb to a terminal illness within six months of entering hospice care. Actual treatment for the terminal illness is stopped during hospice care and only palliative treatment is rendered to manage pain or other side effects of the illness.
Source: The News Herald, “Largest US hospice company sued for Medicare fraud,” May 9, 2013