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Whistleblowers Expose Medicare Fraud in the Hospice Industry

According to The New York Times, there is growing concern that Medicare fraud is being committed in the hospice care industry. Currently, Medicare pays hospice providers a flat rate of $147 to $856 a day, depending on the services rendered and the type of care provided. However, some whistleblowers have stepped forward to report that there are companies that may be taking advantage of the system and providing hospice care to patients that don’t need it.

Considered a palliative care alternative that can be rendered to patients in their homes or at a nursing home or private facility during their last days, hospice care is considered less costly than continuing to provide medical services that will not help a dying patient recover. 1.1 million Medicare clients a year receive hospice care.

However, according to the Medicare Payment Advisory Commission (an independent Congressional oversight panel) 19% of hospice patients are now get this care for longer than six months, even though to qualify one is supposed to have no more than a remaining life expectancy of just that long. Medicare’s hospice bill was over $12 billion in 2009 alone, and MedAc is concerned that the flat rate payment fee is incentive for some providers to choose to service patients who are expected to live longer than six months while they continue to get paid.

Fortunately, there are those in the industry who are stepping forward to report Medicare fraud in the hospice industry. These persons are called whistleblowers. They “blow the whistle” and report a type of misconduct or wrongdoing in an organization.

Choosing to become a whistleblower is a tough decision, and sometimes the threat of retaliation can cause many people to stay silent. Fortunately, there are federal and state laws offering whistleblowers protection from such reprisals and, in some cases where the government ends up recovering money from the wrongdoer, the whistleblower may be entitled to part of the award.

It is important that you are represented by an experienced Boston injury lawyer that can protect you and make sure that you are compensated for doing what is right. Contact our Boston, Massachusetts whistleblower law firm and ask for your free case evaluation.

Concerns About Costs Rise With Hospices’ Use, The New York Times, June 27, 2011
Rapid growth of for-profit hospices raises ethical concerns, study says, Mcknights, May 19, 2011

Related Web Resources:
Hospice Benefits, Medicare (PDF)

Medicare Payment Advisory Commission


More Blog Posts:

Whistleblowers Lawsuits Can Lead to Financial Compensation for Those Brave Enough to Speak Out, Boston Injury Lawyer Blog, January 30, 2011