In his whistleblower fraud lawsuit, Michael Rehfeldt, a former Vitas Healthcare Corp. manager, accuses the hospice care chain of defrauding the US government. Vitas is a unit of Chemed Corp.
Rehfeldt claims that Vitas and health insurers enrolled patients that weren’t fatally ill in Medicare. He is alleging fraudulent billing and false certifications.
Rehfeldt contends that Vitas allegedly benefited from the scam while breaking rules that prevents patients that aren’t facing death from receiving hospice care. He says that when he told his supervisors about the alleged misconduct, they ignored his concerns. Rehfeldt believes this shows that Vitas executives know about the Medicare fraud.
Meantime, the US Justice Department now wants internal documents from Vitas so it can look into the fraud allegations. The government told the district court that it believes that Vitas defrauded Medicaid and Medicare of hundreds of millions of dollars.
In the last 10 years, the number of patients covered under Medicare through Vitas has doubled to 1.1 million. Although the hospice care company cannot comment on ongoing litigation, a spokesperson for Vitas did say that it has consistently complied with the rules of both Medicaid and Medicare.
Rehfeldt is seeking damages on behalf of the US government. As the whistleblower, he is entitled to part of whatever is recovered over the Medicare fraud. The False Claims Act offers this incentive to get whistleblowers to come forward. He is also suing Care Level Management LLC and WellMed Medical Management in his qui tam complaint.
In order to qualify for hospice services under Medicare, a patient must only have six months or less to live. Two doctors must certify that this is true. A patient, however, can stay on longer than that as long as his/her terminal diagnosis is recertified every two months.
Whistleblower Accuses Chemed Unit of Medicare HMO Conspiracy, Bloomberg, November 16, 2011
Texas Lawsuit Identifies Problems In Medicare Hospice Provisions, Kaiser Health News, November 16, 2011
More Blog Posts:
Medicare Fraud?: Cigna, UnitedHealth Group, and Aetna Under Scrutiny for Possible Kickback Violations, Boston Injury Lawyer Blog, November 22, 2011
Whistleblower Lawsuit Accuses Florida Hospital of Defrauding Medicare of $2M, Boston Injury Lawyer Blog, November 15, 2011
Pfizer Settles Whistleblower Claim Alleging Pharmaceutical Fraud Related to Detrol, Boston Injury Lawyer Blog, October 19, 2011
Altman & Altman LLP represents clients with Massachusetts whistleblower cases. Contact our Boston injury lawyers today.