A South Carolina-based hospice company has agreed to settle false claims allegations for $1.287 million, the Department of Justice announced last week.
The United States alleged that Harmony Care Hospice and its owner and CEO, Daniel J. Burton, knowingly submitted to Medicare false claims for patients who did not have a prognosis that warranted hospice care and so were not eligible for hospice Medicare benefits.
[See also: Antifraud efforts net U.S. $4.1B in healthcare fraud recoveries]
"Billing Medicare for unnecessary or inappropriate end-of-life care contributes to the soaring costs of healthcare for everyone," said Stuart F. Delery, principal deputy assistant attorney general of the Justice Department's Civil Division in a statement about the settlement.
As part of the settlement, Burton will have to personally pay $200,000, and he and the company will enter into a Corporate Integrity Agreement with the Office of Inspector General.
The settlement resolves a lawsuit brought by Mona Singletary and Lynda Fulton, former Harmony Care Hospice employees, under the whistle-blower provisions of the False Claims Act. They will split their share of the government's recovery – $244,530.
Counsel for Harmony Care Hospice did not return calls seeking comment.
[See also: Anti-fraud programs saved WellPoint $75M in 2008]
UPDATE: Monday, Nov. 26, 2 p.m. eastern:
"The settlement arose out of conduct that took place in a now closed office in Lake City," said Harmony Care Hospice counsel Sherri Lydon in a voicemail message. "In making the settlement, Harmony made no admissions of wrong doing."
Lydon stressed that the allegations arose out of a personnel issue regarding billing. "... there have never been allegations of poor hospice care," she said. "This was strictly an issue regarding billing."
Lydon said the hospice company has addressed the billing concerns and has implemented safeguards to make sure the company is strictly comlying with all government regulations.