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Top Intervention Rate
Having the Government intervene in a Qui Tam False Claims Act case is the best way to ensure its success. That is why we are extremely proud to have been recognized for having the highest intervention rate in the country.
$100 Million + Recovered
To date the False Claims Act work we have done has led to more than $100 million in recoveries for the U.S. and State Treasuries, with corresponding whistle blower rewards for our clients.
What are the most common types of Hospice Fraud?
The number one form of Hospice Fraud is admitting patients into a hospice program when they do not
Medicare admissions criteria, which that the patients must be terminally ill and have a prognosis of 6 months
or less if their disease runs its normal course. 42 CFR 418.20 § 418.20. Related to this is falsely recertifying
patients as meeting hospice criteria after the initial admission period ends.
To perpetuate this type of billing
fraud, hospice operators have forged physician’s signatures on certification forms and/or recorded false symptoms
and diagnoses on medical records (which are often created after the fact and backdated). Other forms of Hospice
Fraud include: billing for continuous care treatment for patients who do not require round the clock services;
paying illegal kickbacks and bonuses to certifying doctors, marketers/patient recruiters, and nursing homes that
funnel patients to hospices; and billing for hospice services when patients have left the program (for instance,
when they are admitted into a hospital for a condition not related to their terminal illness).
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hospice fraud include: (1) unusually high length of stays in the program; (2) abnormally large numbers of
“live discharges” from hospice; and excessive cases of non-specific terminal illnesses, such as debility
and dementia, combined with smaller numbers of more concrete terminal illnesses, such as aggressive forms
of malignant cancers.