Yesterday the DOJ announced that Gentiva, the successor to Kindred at Home, has agreed to a settlement of roughly $19.5 million. This resolution addresses allegations that Kindred, and its related entities violated the False Claims Act by billing the government for unnecessary hospice services and improperly retained overpayments. The accusations spanned a decade, involving numerous patients who were ineligible for hospice benefits under federal healthcare programs. 

The hospice operations in question, headquartered in Atlanta, include entities that formerly operated under the names Avalon, Kindred, SouthernCare, and SouthernCare New Beacon. The settlement stems from a consolidated complaint filed in 2021 by the United States and the State of Tennessee. The complaint alleged that from 2010 until February 2020, Kindred and its affiliates knowingly submitted false claims for hospice services to patients in Tennessee who were not terminally ill, thereby ineligible for Medicare or Medicaid hospice benefits. 

Principal Deputy Assistant Attorney General Brian M. Boynton, head of the Justice Department’s Civil Division spoke on this issue saying, “The hospice benefit under Medicare and other federal health care programs provides critical services to some of the most vulnerable patients. The department will ensure that this important benefit is used to assist those who need it, and not as an opportunity to line the pockets of those who seek to abuse it.” 

Attorney Henry C. Leventis for the Middle District of Tennessee added, “Hospice provides vital care and support for terminally ill patients and their families. Medicare and TennCare’s eligibility requirements ensure that federal and state health care money is properly used to support hospice programs.” 

The settlement also covers similar allegations involving Kindred’s locations in Warwick, Rhode Island; Beaumont, Texas; and Independence, Missouri; as well as SouthernCare and SouthernCare New Beacon locations in Alabama, Indiana, and Ohio. In these instances, the entities also allegedly submitted false claims for hospice services for patients who were not terminally ill and concealed their obligation to repay the claims. 

Adding to the complexity, SouthernCare New Beacon faced accusations of violating the Anti-Kickback Statute. The Anti-Kickback Statute aims to ensure medical providers’ judgments remain unbiased and in the best interest of their patients, free from improper financial incentives. Between October 2016 and October 2022, they allegedly paid remuneration to a consulting physician to induce hospice referrals of Medicare beneficiaries to their Gadsden, Alabama location. This particular allegation was brought up through a voluntary self-disclosure by someone employed at New Beacon Healthcare Group. 

Deputy Inspector General for Investigations Christian J. Schrank of the Department of Health and Human Services Office of Inspector General (HHS-OIG) stressed the importance of maintaining integrity in hospice care: “The integrity of hospice care is critical to the millions of patients receiving these services. We, along with our law enforcement partners, will continue to ensure that providers who focus on personal financial gain rather than providing medically necessary, high-quality hospice care will be held accountable.” 

If you have information about potential Healthcare Fraud or would like to learn more about Whistleblower protections laws, you can speak to an experienced Constantine Cannon whistleblower lawyer team member. Please don’t hesitate to contact us for a free and confidential consultation.  

Read Hospice Care for Who? Kindred and Related Entities Settle for $19.M   at constantinecannon.com