ATTORNEY NEWSLETTER
Enrolled Ineligible Seniors Into Hospice Programs
Payments For Non-Terminally Ill Patients
How Hospice Fraud Constitutes Elder Abuse
Healthcare fraud against government programs like Medicare costs taxpayers billions every year. When medical service providers like hospice agencies admit ineligible patients into programs where the government is paying the bills, the ineligible admissions of patients constitute fraud. When the targeted patients in the fraudulent scheme are elders, such fraud cases may also constitute elder abuse under the California Elder Abuse and Dependent Adult Protection Act, Cal. Welf. & Inst. Code § 15600 et seq. Medicare fraud often overlaps with elder abuse in hospice programs, nursing homes and assisted care facilities where the elderly patient, as well as the government, is harmed or defrauded by the misconduct of the care provider. Evans Law Firm, Inc. represents California seniors who have suffered elder abuse and individuals with credible information of fraud against government-sponsored healthcare programs. If you have credible information of elder abuse and healthcare fraud in San Francisco, or elsewhere in California, call us today at (415)441-8669 and we can help. Our toll-free number is 1-888-50EVANS (888-503-8267).
Charges Against Hospice Agency For Fraud And Abuse
California Attorney General Rob Bonta recently announced the arrests of 14 individuals who were charged with stealing more than $4.2 million from the federal Medicare and state Medi-Cal programs through two hospice agencies they ran.[1] The complaint alleges that the defendants enrolled patients who were not terminally ill into hospice care, many of whom told investigators that they were enrolled without their knowledge or understanding of what hospice was. “End-of-life care is a difficult process for families to endure, and patients should be able to trust that their hospice providers are acting in good faith,” said Attorney General Bonta. “The crimes allegedly committed by the defendants against their patients, Medicare, and our state’s Medi-Cal program will not be tolerated. My office is committed to protecting the well-being of Californians and prosecuting those who abuse the financial integrity of our healthcare system.”
From 2015 to 2021, the defendants allegedly billed Medicare and Medi-Cal for millions of dollars, fraudulently claiming that they were providing hospice care to patients who had less than six months to live when in fact these patients were not terminally ill. According to the AG’s press release, defendants allegedly took patient identity information and put them in hospice without their knowledge; falsely representing to patients what services they would be receiving; and billing patients with one company, only to switch them to the other company in order to avoid detection.
How The Fraud Constitutes Elder Abuse
When a patient is enrolled in hospice care, they give up their opportunity under the Medicare and Medi-Cal programs to receive medical treatment to prolong their life, such as chemotherapy for cancer patients. As a result of the defendants’ alleged actions, numerous ineligible patients were incorrectly certified as terminally ill and tricked into receiving hospice services, which would have made access to potentially lifesaving medical care difficult in the event that any of them required it. Thus, the fraud of putting seniors into hospice and cutting off life-prolonging medical care is an extremely dangerous and potentially lethal form of elder abuse. See, e.g., Cal. Welf. & Inst. Code § 15610.07(a)(2)(deprivation of necessary services constitutes abuse).
Contact Us
If you have credible information of fraud against government healthcare programs and/or resulting elder abuse in San Francisco or elsewhere in California, call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=”mailto:info@evanslaw.com”>info@evanslaw.com</a>.
[1] Evans Law Firm, Inc. is not involved in the case in any way.
