Miami-based care provider Vitas Hospice Services LLC and related companies reached a $75 million agreement with the federal government to settle claims of Medicare overbilling.
“Today’s resolution represents the largest amount ever recovered under the False Claims Act from a provider of hospice services,” said Acting Assistant Attorney General Chad Readler of the Justice Department’s Civil Division on Monday. “Medicare’s hospice benefit provides critical services to some of the most vulnerable Medicare patients, and the department will continue to ensure that this valuable 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.”
Vitas is the largest for-profit hospice chain in the country and was purchased in 2004 by Cincinnati-based Chemed Corp. The agreement involves Chemed and subsidiaries including Vitas Hospice Services and Vitas Healthcare Corp., which operate out of 201 S. Biscayne Blvd. in downtown Miami.
“We’ve elected to settle the civil litigation without any admission of wrongdoing to avoid the cost and uncertainty of protracted litigation,” Vitas CEO Nick Westfall said in a statement. “We continue with our commitment, since the inception of the hospice benefit, to provide a comprehensive offering of compassionate, high-quality care to patients and families across the country.”
The settlement stems from allegations that Vitas billed Medicare for hospice services for patients who were not terminally ill. Vitas also billed the program for improperly delivered, unnecessary or fabricated home care services, the government claimed. The alleged false claims were filed between 2002 and 2013.
Under the law, care providers may only submit Medicare claims for hospice benefits for patients who are expected to die within six months. Electing the hospice benefit also means patients give up the right to curative care focused on treating an illness. The government claimed Vitas gave employees bonuses based on how many patients received hospice services — even if those patients could have benefited from curative care.
Vitas also incentivized employees to improperly bill Medicare for continuous home care services, as the program pays hundreds of dollars more per day for those services than routine hospice services, the government claimed.
The company ”used aggressive marketing tactics and pressured staff to increase the volume of continuous home care claims, without regard to whether the patients actually required this level of crisis care,” according to the Justice Department.
The settlement includes a five-year corporate integrity agreement with the Department of Health and Human Services.
Vitas said in a statement the company fully cooperated with the Justice Department but continues to disagree with the claims.
“This civil litigation concerned professional disagreement between physicians in reaching a terminal prognosis as well as physician judgment in determining appropriate levels of care,” the statement said.
The settlement stems from four lawsuits consolidated in the Western District of Missouri.
Vitas was represented by Hogan Lovells attorneys Peter Spivack in Washington, D.C., and Stephanie Carman in Miami, as well as Husch Blackwell attorneys Stacey Bowman in Denver and Harvey Tettlebaum in Jefferson City, Missouri.