By: Christopher A. Parrella, Esq., CPC, CHC, CPCO
Parrella Health Law, Boston, Ma.
A Health Law Defense and Compliance Firm

Kindred at Home, now succeeded by Gentiva, and its related entities have agreed to pay $19.428 million to resolve allegations of submitting false claims and retaining overpayments for hospice services provided to ineligible patients. This settlement includes various hospice locations previously operating under names such as Avalon, Kindred, SouthernCare, and SouthernCare New Beacon.

Medicare and Medicaid Hospice Fraud


The settlement addresses allegations that from 2010 to February 2020, Kindred entities submitted false claims for hospice services for patients not terminally ill, violating Medicare and Medicaid eligibility requirements. Specific locations in Rhode Island, Texas, Missouri, Alabama, Indiana, and Ohio were implicated in these fraudulent practices.

Anti-Kickback Statute Violations


The settlement also resolves allegations that SouthernCare New Beacon paid illegal kickbacks to a consulting physician to induce hospice referrals, violating the Anti-Kickback Statute. This statute is designed to prevent financial incentives from compromising medical judgment and patient care.

Commitment to Patient Care


Principal Deputy Assistant Attorney General Brian M. Boynton emphasized the importance of the hospice benefit for vulnerable patients, stating, “The department will ensure that this important benefit is used to assist those who need it, and not as an opportunity to line the pockets of those who seek to abuse it.”

Legal and Financial Accountability


U.S. Attorney Henry C. Leventis for the Middle District of Tennessee and other officials underscored the commitment to holding healthcare providers accountable for prioritizing profits over patient care. The settlement ensures federal and state healthcare funds are used appropriately to support eligible hospice patients.

Whistleblower Involvement


The settlement resolves claims from nine lawsuits brought under the False Claims Act’s whistleblower provisions. These actions highlight the critical role whistleblowers play in exposing healthcare fraud.

Conclusion


This settlement demonstrates a concerted effort by federal and state authorities to maintain the integrity of healthcare programs and ensure that hospice services are provided to those truly in need. The resolution of these allegations not only holds Kindred and its related entities accountable but also reinforces the commitment to protecting taxpayer dollars and patient care standards.

For more information on navigating healthcare compliance and regulatory challenges within the hospice context, contact Parrella Health Law at 857.328.0382 or email me directly at cparrella@parrellahealthlaw.com.

Christopher Parrella, ESQ, CPC, CHC, CPCO, is the founding partner of Parrella Health Law in Boston, Mass. The firm focuses exclusively on healthcare defense and compliance matters. Chris also travels the country on behalf of a wide range of healthcare organizations, lecturing on a variety of health care enforcement and compliance topics. Chris is one of a handful of health care attorney’s that are also Certified Professional Coders (CPC) and is a member of the AAPC’s National Legal Advisory Board and Ethics Committee.  He is also a Certified Professional Compliance Officer (CPCO) and Certified in Health Care Compliance (CHC.)