Hospice Care, a service of the National health insurance program in the United States for persons aged 65 years and older Medicare, finds patients who need care, provide families with false information about what aid will be provided to elderly patients, and then expose millions of accounts for the alleged services rendered, according to the report published by the Office of inspection General (OIG) of the Ministry of health.
Hospice does not provide treatment, but rather services that minimize pain for patients whose lives are coming to an end, reports OCCRP. The report shows that Hospice Care takes advantage of a vulnerable population and subsequently does not provide the promised services. Hospice Care also puts at risk healthy people who are able to recover with the right treatment.
The report points to one example in which hospice representatives told a woman that she could remain on the list for a liver transplant, even if she chose Hospice Care. When she did, she was removed from the waiting list for a transplant.
The report of the Ministry of health also says that doctors received payment for the recruitment of patients in the hospice, although they were not terminally ill.
The report goes on to say another egregious case: the owner of a California hospice illegally paid doctors to recruit patients, detect fraudulent diagnoses and change their medical records, and assure patients that they were terminally ill, even though it wasn’t really. The owner pleaded guilty and was sentenced to eight years in Federal prison.
Hospice Care is also provided to the families the documents in which it was noted that the care in hospice is not curative, that have misled patients who were not terminally ill.
In addition, hospices were charging Medicare exorbitant amounts for services that the centers did not provide. In 2016, Medicare paid $ 16.7 billion for hospice care, 81% more than in 2006, and the number of patients in the hospice increased by only 53%.
In one case, a Mississippi hospice owner received over $ 1 million from Medicare for two patients who didn’t even know they were registered.
Medicare provided payments ranging from $ 447,000 to $ 1.2 million for services that did not meet Medicare requirements due to inadequate care or billing for services provided to patients who were not terminally ill. The centers also billed for serious and intensive care when the patient needed regular home care, allowing hospices to receive $ 672 a day from Medicare, rather than $ 151 a day.
Hospice in new York hired Medicare employees for one month of continuous home care, the cost was $ 1 million 266 thousand 517, although the patient had already died.
The national hospice organization stated that these examples are exceptions and not representative of routine operations. “NHPCO continues to emphasize that the cases cited in the report do not reflect an adequate context for the provision of hospice services in the United States,” the President and CEO of the national hospice organization Edo Banach said in a statement.
“It should be understood that rare cases of intentional fraud and abuse should be treated separately from unintended documentation or mathematical errors in an extremely burdensome and complex regulatory environment,” he said.
The inspector General’s report also affects the payment system underlying hospice services. “Hospice payments do not include any adjustments or other payments that are related to the quality of service provided by hospices,” the report said.
Several recommendations were made in the report, but it is not clear whether any action will be taken.