Hospice accused of detaining, billing patients who were not terminally ill

A central Florida hospice is being sued for Medicare fraud, accused of claiming Medicare reimbursements for patients who were not diagnosed as terminally ill. If allegations prove true, the hospice company could owe $11 million for Medicare overbillings since 2005 and millions more in fines.

The lawsuit filed last week is the second one against Hospice of the Comforter, Altamonte Springs, Fla., in the past two years. The suits allege that the facility’s former CEO, Robert Wilson, instructed his employees to skip the Medicare-required verification of whether a patient was actually terminally ill and to tweak documentation to make the billings look genuine, the Orlando Sentinel reported Monday.

The original whistleblower lawsuit, which the Department of Justice took over in September, was brought by Douglas Stone, the hospice’s former vice president of finance. As a witness for the prosecution, Stone will be eligible for up to 25 percent of the settlement, noted the Orlando Sentinel.

“Some of the most vulnerable people in our district rely on hospice services,” said Robert O’Neill, U.S. Attorney for the Middle District of Florida, in a statement on the original lawsuit. “It is critically important that Medicare remains solvent in order to provide hospice benefits, and that we confront those whose practices in this area put economic gain before patient care.”

Pamela Tabar

Pamela Tabar was editor-in-chief of I Advance Senior Care from 2013-2018. She has worked as a writer and editor for healthcare business media since 1998, including as News Editor of Healthcare Informatics. She has a master’s degree in journalism from Kent State University and a master’s degree in English from the University of York, England.