News Column

Feds Sue Hospice of the Comforter, Allege Medicare Fraud

Jan. 14, 2013

Kate Santich

The federal government is suing Hospice of the Comforter for Medicare fraud, alleging that for years the Altamonte Springs-based nonprofit knowingly billed for patients who were not deemed terminally ill. The facility could face millions of dollars in fines and damages as a result.

The suit, filed late last week, repeats allegations first made by a former executive for the hospice, Douglas Stone, who filed his own whistleblower case more than a year ago.

The suit by the U.S. Attorney's Office alleges that longtime hospice CEO Robert Wilson instructed employees to admit patients without determining whether they were terminally ill, as Medicare requires, and then to bill the federal program for reimbursement. Staff also was instructed to find "creative" ways to document the case in the patient's medical file so that the billings appeared legitimate.

The fraudulent billings date back to 2005, the suit says. The hospice administration allegedly went so far as to limit medical review by a physician who was supposed to determine that patients were terminally ill. Further, if a review committee recommended that a patient be discharged, the hospice would order more tests to delay the discharge and continue billing Medicare, the suit says.

Wilson also had a list of patients -- whom nurses referred to in notes as FOBs, or "friends of Bob" -- who were not to be discharged regardless of what reviewers found, the suit says.

Hospice of the Comforter, now under a management agreement with Adventist Health System, the parent company of Florida Hospital chain, faces millions of dollars in damages and fines if the government wins its case.


Distributed by MCT Information Services

Source: (c) 2013 The Orlando Sentinel (Orlando, Fla.)

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