Hospices provide palliative care to patients who decline curative care of their illness. Palliative care is medical treatment that concentrates on reducing the severity of pain and other disease symptoms. Medicare beneficiaries are entitled to hospice care if they have a terminal illness with a prognosis that their life expectancy is six months or less.
The lawsuit alleged that Harmony Care Hospice and its owner knowingly submitted false claims to Medicare for patients who did not have such a prognosis and thus were not eligible for hospice care reimbursement.
The two hospice employees, Mona Singletary and Lynda Fulton, started the government’s investigation by filing a lawsuit under the qui tam, or whistleblower, provisions of the False Claims Act. This law allows private citizens to start lawsuits for false claims on behalf of the United States government and share in any recovery. The individuals who file the lawsuit are called “relators.”
The qui tam lawsuit was filed by the relators “under seal” (in secret) so the U.S. Attorney could review the evidence and conduct an investigation without alerting the defendants that they were being investigated. The case became public only after the U.S. Attorney conducted an investigation and decided to join the lawsuit.
Under the False Claims Act, qui tam relators are entitled to a reward of between 15% and 25% of the amount recovered when the government joins the lawsuit. In this case, the relators will receive a reward of almost $250,000, or a little more than 19% of the $1.3 million settlement amount.
If you have information that false claims are being submitted to Medicare or Medicaid, then you should consult with an experienced False Claims Act attorney immediately to protect your rights. To arrange a free and confidential consultation by phone or in person, call my office today at (917) 652-6504 or click here to contact me via email.
John Howley, Esq.
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