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Whistleblower Lawsuit Accuses Southern Care of Charging Medicare While Fraudulently Enrolling Patients in Hospice Care

A former SouthernCare employee has filed a whistleblower complaint against the hospice company. Karina Christensen is accusing Southern Care of charging Medicare for hospice care that was given to treat patients who weren’t dying.

In order to have hospice care covered under Medicare, a doctor must have determined that the patient have no more than six months to live before it will agree to cover the costs. Hospice care is focused on helping decrease the severity of the disease’s symptoms during the last months of the patient’s life.

Christensen contends that not only did her supervise encourage this type of fraudulent enrollment in hospice care, but also they disregarded her complaints that this was against the law. Soon after she wrote a letter to the regional director and the board of directors about her concerns in 2010, she was fired from her job. Christensen worked as a clinical director at SouthernCare’s Madison office in Alabama.

Christensen that it would usually be several days after patients were enrolled and Medicare had been charged that she would receive medical information about them. She says that among the patients who were given hospice care was someone who supposedly was dying of cancer but was, in fact, cancer-free. There was also a heart disease patient who exhibited no symptoms of the condition.

SouthernCare, which is a for-profit company that has 75 offices in 15 states, settled similar claims in Alabama in 2009 by paying the federal government $24.7 million. The settlement stemmed from two whistleblower/qui tam complaints submitted by two ex-SouthernCare employees. Per the False Claims Act, which entitles whistleblowers that file lawsuits against parties that defrauded the government to part of the recovery, both women were to receive $4.9 million.

Medicare Billing Fraud
Unfortunately, it is the taxpayers who end up for paying for Medicare billing fraud. Meantime, money that should be treating patients who actually need this care ends up going to the wrongdoers.

Fortunately, the government has established laws to reward and protect those within the industry who come forward and report such wrongdoing. The whistleblower may even be entitled to up to 30% of what the government collects.

Whistle-blower suit accuses hospice company of Medicare fraud, Madison.com, September 14, 2011
Alabama-Based Hospice Company Pays U.S. $24.7 Million to Settle Health Care Fraud Claims, Department of Justice, January 15, 2009
The Federal False Claims Act, TAF.org

More Blog Posts:

Massachusetts Whistleblower Lawsuits, Hospice Neglect, and Medicare Fraud, Boston Injury Lawyer Blog, July 26, 2010
Pharmaceutical Fraud May Be Grounds for Filing a Massachusetts Whistleblower Lawsuit, Boston Injury Lawyer Blog, July 23, 2011
Whistleblowers Expose Medicare Fraud in the Hospice Industry, Boston Injury Lawyer Blog, June 28, 2011
You should speak with an experienced Boston whistleblower law firm to explore your legal options.