Case Involving Alleged Submission Of False Claims For The Provision Of Hospice Care Results In $1.286 Million Settlement

Hospices provide individuals who decide not to seek a cure for their medical conditions with treatments aimed at reducing the severity of their symptoms.  Medicare beneficiaries are entitled to receive hospice care if they have been diagnosed with six months or less to live.  The United States claimed that South Carolina-based Harmony Care Hospice, Inc. and its owner and CEO, Daniel J. Burton, had knowingly submitted or caused to be submitted claims to Medicare seeking payment for care given to patients who did not have this prognosis.

Harmony and Mr. Burton have agreed to pay $1,286,999.32 to settle the allegations against them.  Mr. Burton will be required to pay $200,000 of this amount himself.  Two former Harmony employees, Mona Singletary and Lynda Fulton, who filed a whistleblower suit against the company, will receive a total of $244,529.87 as their share of the government’s recovery.

In addition to the monetary payment, Harmony and Mr. Burton will enter a Corporate Integrity Agreement with the Office of Inspector General, Department of Health and Human Services, to address the allegations which were made in the lawsuit.  Daniel R. Levinson, the Inspector General of the United States Department of Health and Human Services, stated, “[a]s budget pressures increase it is more important than ever to protect Medicare dollars and vigilantly guard against needless health spending” and that Harmony and Mr. Burton “…have agreed to Federal monitoring and reporting requirements designed to avoid such problems in the future.”

The claims against Harmony and Mr. Burton were settled without a determination of liability.

This case is an outgrowth of the government’s emphasis on combating health care fraud and part of the Health Care Fraud Prevention and Enforcement Action Team.  This team represents a partnership between the United States Departments of Justice and Health and Human Services and focuses on reducing and preventing Medicare and Medicaid financial fraud through enhanced cooperation between the agencies.  Since January of 2009, the Justice Department has recovered $10.1 billion under the False Claims Act in cases involving fraud against federal health care programs.

For more information, please see:
http://www.justice.gov/opa/pr/2012/November/12-civ-1401.html