Arizona hospice companies agree to $12 million settlement in false billing whistleblower case

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Two hospice providers and their parent company recently agreed to a $12 million settlement with the federal government in a whistleblower case over Medicare claims.

A former Hospice of Arizona LC employee, Ellen Momeyer, alleged workers at Hospice of Arizona and a related company, American Hospice Management LLC, submitted false Medicare claims between 2002 and 2010 for unneeded care or for care provided to ineligible residents. Hospice of Arizona provides care to about 30,000 people in the state, including residents of skilled nursing facilities.

The hospice providers do not admit wrongdoing under the terms of the settlement, and say most of the claims at issue are old, from the period before American Hospice Management acquired Hospice of Arizona.

“The large majority of reimbursements challenged by the DOJ were related to admissions prior to American Hospice's 2004 acquisition of HOA and the institution of robust compliance and electronic medical record systems,” according to a release provided by the defendants' attorney. “Rather than continuing to challenge interpretation of decade-old clinical documentation, the company deemed it best to conclude this chapter and move forward with a continued focus on service excellence.”

American Hospice Management Holdings LLC, the parent company in the case, will institute a corporate integrity agreement as part of the settlement. Momeyer will receive $1.8 million of the settlement money.