The purpose of a hospice is to provide terminally ill patients with palliative care. It is a specific type of health care that seeks to provide dying individuals with as much comfort as possible during their last days. As is explained by its very definition, a hospice is a place where, sadly, nothing more can be done for patients. Preventing and alleviating suffering take precedence over finding a cure.
Of course, if a cure for the illness can be found, a hospice is no place for a patient. However, as Peter Whoriskey reveals in The Washington Post, a 2014 investigation found that there is a growing number patients who have been outliving hospice care in the United States over the past ten years. Evidently, hospice companies are recruiting patients who aren’t actually dying. To say that such actions are unjust is an understatement.
Patients deserve as much information about their health conditions as possible. That way, they can make informed decisions about the best courses of action to either remedy their illnesses or seek the types of care that would ease their suffering. Clearly, one course of action involves a hope that the illness can be overcome. The other is a preparation for death. Needless to say, there is a huge difference between the two.
Nevertheless, Whoriskey informs that the Office of Inspector General of the Department of Health and Human Services released a report last month declaring that “about one in three hospice patients were not given key information about what the choice of hospice entails at the time they enrolled…In many cases, the patient was not informed that electing hospice meant that they intended to forgo a cure for their terminal illness — a critical distinction between hospice care and other health services.”
The team, here at Allegiant Experts, cannot stress enough how alarming and deplorable this is. Imagine coming to terms with a death sentence only to realize you were not terminally ill after all. We certainly can’t. According to the OIG report, about 14 percent of the reviewed cases involved doctors who approved patient enrolment in hospice care, but provided little information about the patient’s prognosis and “appeared to have limited involvement in determining that the (patient) was appropriate for hospice care.”
And as if the enrolment of non-terminally ill patients into hospices wasn’t bad enough, Medicare gets stuck with the bills for their care. The government insurer paid $15.1 billion in hospice services in 2013, reports Whoriskey. This covered 1.3 million people. “The federal government in recent years has sought to recover more than $1 billion from hospices that, according to attorneys, illegally billed Medicare for patients who weren’t near death,” he informs.
What makes the entire dilemma even sadder is the fact that patients who aren’t near death are considered more profitable by the hospices. Because hospices are paid flat daily rates for their patients, and non-terminally ill patients require fewer services, the hospices are able to pocket cash. According to a spokesman for the Office of Inspector General at HHS, investigations have been opened to look into several hundred hospice fraud schemes.
This is one of the sicker instances of Medicare fraud that the Allegiant Experts Blog has covered. While Whoriskey reveals that it is normal for hospices to release small portions of patients before death (about 15 percent), research has showed that “at some hospices, and particularly at new, for-profit companies, the rate of patients leaving hospice care alive is double that level or more.”
Health insurance fraud like this simply needs to stop. It not only robs Medicare of money, it robs people of precious time in their lives. The team, at Allegiant Experts is committed to doing its part to eliminate such instances of fraud in our country. For more information about how our team of clinical experts can assist your litigations against those who commit health insurance fraud, please don’t hesitate to contact us at 407-217-5831.
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