On November 23, the U.S. Department of Justice (DOJ) announced that a hospice care provider will pay $5.5 million “to resolve allegations that they violated the False Claims Act by submitting claims to Medicare for non-covered hospice services.”
Carrefour Associates LLC, Crossroads Hospice of Cincinnati LLC, Crossroads Hospice of Cleveland LLC, Crossroads Hospice of Dayton LLC, Crossroads Hospice of Northeast Ohio LLC, and Crossroads Hospice of Tennessee LLC are together known as Crossroads Hospice in this press release. They operate in Ohio and Tennessee, and the DOJ states that the settlement “resolves allegations that Crossroads Hospice knowingly submitted false claims to Medicare for hospice services for patients who were not terminally ill.”
Hospice care, the DOJ explains in the press release, “is special, end-of-life care intended to comfort terminally ill patients.” Patients in hospice care “generally stop receiving coverage for traditional medical care designed to cure their terminal condition,” instead shifting to “receive medical care focused on provided them with relief from the symptoms, pain and stress of a terminal illness.” According to the press release, “Medicare patients are considered to be terminally ill and hospice-eligible when they have a life expectancy of six months or less if their illness runs its normal course.”
The settlement describes that the U.S. alleged that between January 1, 2012, to December 31, 2014, “Crossroads Hospice billed Medicare...
The Centers for Medicare & Medicaid Services (CMS) and its audit contractors have the authority to suspend payments to hospice care providers suspected of submitting false claims or improperly...