Guardian Hospice to pay $3 million to settle Medicare fraud allegations

Guardian Hospice of Georgia has agreed to pay $3 million to  resolve allegations it submitted claims to Medicare for hospice patients who were not terminally ill, according to the Department of Justice, Northern District of Georgia.

The settlement with Guardian Hospice and its holdings, Guardian Home Care Holdings and AccentCare, was announced Friday. Guardian is a for-profit hospice in Atlanta.

[Also: Running list of notable 2015 healthcare frauds]

Guardian submitted false claims for hospice care for patients who did not have a terminal prognosis of six months or less, according to authorities. It also failed to properly train staff and medical directors on hospice eligibility criteria, set aggressive targets to recruit and enroll patients, and failed to properly oversee the Atlanta hospice, the Justice Department stated.

The case was originally brought by former employee whistleblowers Rose Betts and Jennifer Williams, who will share in the recovery.  They will receive approximately $510,000, according to the Justice Department.

The settlement makes no determination of liability.

The Medicare hospice benefit is available for patients who elect palliative treatment for relief from pain, symptoms or stress for a terminal illness and have a life expectancy of six months or less.

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Before billing Medicare, a hospice provider is obligated to ensure that patients who are foregoing curative care are in need of end of life care.

"The Medicare hospice benefit is intended to provide comfort and care to patients nearing the end of life," said Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department's Civil Division. "We will continue to aggressively pursue companies that abuse the Medicare hospice benefit to improperly inflate their profits."

Twitter: @SusanJMorse