PHOENIX – Serenity Hospice and Palliative Care, a hospice operating in Phoenix, Ariz., has agreed to pay $2.2 million to resolve civil allegations that it violated the federal False Claims Act by submitting false bills to Medicare for hospice services.
“The Medicare hospice benefit is intended for terminally ill patients who need end-of-life care,” said United States Attorney John S. Leonardo. “The U.S. Attorney’s Office will continue to use all legal means at its disposal to ensure that this benefit is not misused for anything other than providing hospice care for qualified patients at the appropriate level of care.”
“Being a hospice provider in the Medicare program is a privilege, not a right. Hospice providers and executives that seek to boost profits by providing hospice services to Medicare beneficiaries whose medical condition does not warrant hospice care compromise both the health of its patients as well as the integrity of Medicare,” said Christian J. Schrank, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General. “Our agency will continue to hold such hospice providers accountable for their actions.”
The Medicare hospice benefit is available for patients who elect palliative care (medical care focused on providing patients with relief from pain, symptoms, or stress) for a terminal illness and who have a life expectancy of six months or less if their illness runs its normal course. When a Medicare patient is admitted to hospice, that individual is no longer entitled to Medicare coverage for care designed to cure his or her illness. The settlement agreement resolves allegations that Serenity knowingly submitted false claims for payment to Medicare for hospice patients. In addition to agreeing to pay $2.2 million, Serenity agreed to enter a five-year corporate integrity agreement with the United States Department of Health and Human Services, Office of the Inspector General. Finally, Ruth Siegel, a former nurse and the founder and former president of Serenity, also agreed to be excluded from Medicare, Medicaid, and all other federal health care programs for five years, effective immediately.
The settlement is neither an admission of liability by Serenity nor a concession by the United States that its claims are not well founded.
The settlement resolves a lawsuit filed in February 2014 by Cheryl Sifford under the qui tam, or whistleblower, provisions of the False Claims Act, which allow private citizens to bring civil actions on behalf of the United States and share in any recovery obtained. The case was filed in the United States District Court for the District of Arizona and is captioned United States ex rel. Sifford v. Serenity Hospice and Palliative Care (CV-14-00225-PHX-GMS). Ms. Sifford will receive a share of the settlement payment that resolves the qui tam suit she filed.