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January 02, 2012 11:00 PM

Feds file suit against hospice provider AseraCare

Joe Carlson
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    The federal government has filed a False Claims Act whistle-blower lawsuit against hospice provider AseraCare (PDF), alleging the company pressured its staff to admit Medicare patients and keep beneficiaries in treatment when they didn't need end-of-life care.

    Officials with AseraCare denied the lawsuit's allegations (PDF), saying patients' long-term medical needs can be unpredictable, which is why the federal government only requires that two physicians certify a patient has six months to live in order to justify hospice treatment.

    The lawsuit says that under hospice rules, only Medicare beneficiaries with six months to live can forgo traditional healing treatments and instead become eligible to receive palliative care designed to comfort them in their last months of life. However, patient records cited in the government's lawsuit show diagnoses for supposedly end-stage diseases for which medical records didn't seem to show the symptoms.

    The lawsuit was originally filed in March 2009 by two former employees of AseraCare Hospice, a subsidiary of Golden Living, which has corporate offices in Plano, Texas. The U.S. Justice Department filed a complaint Dec. 6 to intervene in the case as a plaintiff, and the complaint was unsealed Dec. 22.

    The AseraCare employees alleged they were pressured by management to keep patient censuses high, even after auditors documented concerns with levels of staff training and employees' comprehension of hospice regulations, the lawsuit says.

    AseraCare General Counsel David Beck said in an e-mailed statement that the allegations are without merit.

    Company President and Chief Medical Officer Dr. David Friend said in the statement that AseraCare has evolved in recent years to treat more terminally ill patients with “unpredictable disease progressions” who may outlive the predictions for how end-stage diseases will affect them.

    In the statement, Beck quoted former CMS Administrator Nancy Ann DeParle as once saying that hospice beneficiaries are not limited to six months of treatment as long as they continue to receive two physicians' certifications of eligibility for hospice.

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