2018 Vulnerabilities in Hospice Care

OIG is committed to ensuring that beneficiaries receive quality care and to safeguarding the hospice benefit. The agency has completed extensive work on the hospice program, including numerous evaluations and audits. OIG has also conducted criminal and civil investigations of hospice providers, leading to the conviction of individuals, monetary penalties, and civil False Claims Act settlements.

Portfolio

Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio

Hospice is an increasingly important benefit for the Medicare population. This portfolio describes the growth in hospice utilization and reimbursement and summarizes key vulnerabilities that OIG has identified and continues to monitor. The portfolio also includes recommendations to the Centers for Medicare & Medicaid Services to address these vulnerabilities.

Other Resources

• Hospice Report 2018 Audio News Release Transcript

• Text-based version of graphics
• STAT Op-Ed by Joanne M. Chiedi
  Fraud, waste, and abuse in the Medicare hospice program is 'repellent'

Other Reports on Hospices

• Hospices Should Improve Their Election Statements and Certifications of Terminal Illness (OEI-02-10-00492)
• Hospices Inappropriately Billed Medicare Over $250 Million for General Inpatient Care (OEI-02-10-00491)
• Hospice of New York, LLC, Improperly Claimed Medicare Reimbursement for Some Hospice Services (A-02-13-01001)
• Medicare Hospices Have Financial Incentives To Provide Care in Assisted Living Facilities (OEI-02-14-00070)

Enforcement Actions

• Caris Agrees to Pay $8.5 Million to Settle False Claims Act Lawsuit Alleging That it Billed for Ineligible Hospice Patients (June 25, 2018; U.S. Department of Justice)
• Health and Palliative Services of the Treasure Coast, Inc., The Hospice of Martin and St. Lucie, Inc., and Hospice of the Treasure Coast, Inc. Paid $2.5 Million to Settle False Claims Allegations (May 18, 2018; U.S. Attorney; Southern District of Florida)
• Hospice Company and Owner Agree to Pay $1.24 Million to Settle Two False Claims Act Whistleblower Lawsuits (February 8, 2018; U.S. Attorney; Western District of Pennsylvania)
• Chemed Corp. and Vitas Hospice Services Agree to Pay $75 Million to Resolve False Claims Act Allegations Relating to Billing for Ineligible Patients and Inflated Levels of Care (October 30, 2017; U.S. Department of Justice)

Last updated May 4, 2021